Blood test, clotting time (PT/INR)
Facility: St Joseph Health System, LLC
Billing Code: 85610 (CPT)
- CPT Billing Code: 85610
- Insurance Median: $7
- Cash Discount Price: $4
- vs. Medicare Baseline: 1.63x 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.
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 |
|---|---|---|
| Amish Aid | $1 - $32 | 23% |
| Cigna | $1 - $135 | 23% |
| Lutheran Preferred | $1 - $81 | 23% |
| Self Pay | $1 - $74 | 23% |
| Aetna | $2 - $92 | 47% |
| Blue Cross Blue Shield | $2 - $49 | 47% |
| Encore Ppo | $2 - $122 | 47% |
| Lutheran Network | $2 - $74 | 47% |
| Php | $2 - $54 | 47% |
| Sagamore | $2 - $73 | 47% |
| Three Rivers | $2 - $61 | 47% |
| UnitedHealthcare | $2 - $67 | 47% |
| Align Network | $3 - $108 | 70% |
| First Health | $3 - $101 | 70% |
| Frontpath Health Coalition | $3 - $108 | 70% |
| Multiplan | $3 - $105 | 70% |
| Prime Health Services | $3 - $101 | 70% |
| Tricare | $3 - $4 | 70% |
| Advantage Health Solutions | $4 - $112 | 93% |
| Allied Benefit Systems | $4 - $122 | 93% |
| Caresource | $4 | 93% |
| Department Of Veterans Affairs | $4 | 93% |
| Humana | $4 | 93% |
| In Dept Of Correction | $4 | 93% |
| Managed Health Services | $4 - $9 | 93% |
| Medicaid / KanCare | $4 | 93% |
| Medical Mutual Of Ohio | $4 - $135 | 93% |
| Medicare (plans) | $4 | 93% |
| Node Devoted Health Mcr Adv | $4 | 93% |
| Node Hospice Non Par Agree | $4 | 93% |
| Node Pphp Mcr Adv | $4 | 93% |
| Node Va | $4 | 93% |
| Parkview Healthplan Services | $4 - $135 | 93% |
| Php Freedom Network | $4 - $8 | 93% |
| Value Options | $4 - $135 | 93% |
| Veterans Eval Services | $4 | 93% |
| Us Department Of Labor | $5 | 117% |
| Lutheran Advanced Network | $6 | 140% |
| Encore Work Comp In | $8 | 186% |
| Work Comp | $9 | 210% |
| Encore Kba Epo | $10 | 233% |
| Encore Kba Ppo | $13 | 303% |