Blood test, clotting time (PT/INR)
Facility: Lower Keys Medical Center
Billing Code: 85610 (CPT)
- CPT Billing Code: 85610
- Insurance Median: $9
- Cash Discount Price: $4
- vs. Medicare Baseline: 2.10x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Understanding this gauge: We use the federal Medicare rate of $4.29 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 210% of the Medicare baseline (a markup of 110%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Blue Cross Blue Shield | $3 - $134 | 70% |
| Florida Childrens Medical Services | $3 | 70% |
| Medicaid / KanCare | $3 - $4 | 70% |
| Self Pay | $3 - $47 | 70% |
| Simply Healthcare | $3 - $42 | 70% |
| South Florida Community Care Network | $3 | 70% |
| UnitedHealthcare | $3 - $103 | 70% |
| Amerigroup | $4 | 93% |
| Fl Work Comp | $4 | 93% |
| Heritage Summit Work Comp Fl | $4 | 93% |
| Humana | $4 | 93% |
| Magellan | $4 | 93% |
| Medicare (plans) | $4 | 93% |
| Molina | $4 | 93% |
| Node Champva | $4 | 93% |
| Node Non Par Hospice Agree | $4 | 93% |
| Node United Behavioral Va Ccn | $4 | 93% |
| Node Va | $4 | 93% |
| Positive Healthcare | $4 | 93% |
| Prestige Health Choice | $4 | 93% |
| Prime Health Work Comp Fl | $4 | 93% |
| Tricare | $4 | 93% |
| Ultimate Health | $4 | 93% |
| Veterans Eval Services | $4 | 93% |
| Wellcare | $4 | 93% |
| Wellcare Healthease | $4 | 93% |
| Correct Care Solutions | $5 | 117% |
| Node Us Dept Of Labor | $5 | 117% |
| Cigna | $6 - $79 | 140% |
| Aetna | $7 - $94 | 163% |
| Evolutions Healthcare Systems | $7 - $128 | 163% |
| Keys Energy | $7 - $108 | 163% |
| Monroe County | $7 - $101 | 163% |
| Prime Health Ppo | $7 - $108 | 163% |
| Avmed Health Plan | $8 - $114 | 186% |
| Direct Healthcare | $9 - $134 | 210% |
| State Auto Insurance Fl | $9 | 210% |