Blood test, clotting time (PT/INR)
Facility: The Orthopaedic Hospital of Lutheran Health Networ
Billing Code: 85610 (CPT)
- CPT Billing Code: 85610
- Insurance Median: $9
- Cash Discount Price: $6
- 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 - $7 | 70% |
| Aetna | $4 - $41 | 93% |
| Amish Aid | $4 - $23 | 93% |
| Caresource | $4 | 93% |
| Department Of Veterans Affairs | $4 | 93% |
| Humana | $4 | 93% |
| In Dept Of Correction | $4 | 93% |
| Iu Health Plan | $4 | 93% |
| Lutheran Preferred | $4 - $51 | 93% |
| Managed Health Services | $4 - $9 | 93% |
| Medicaid / KanCare | $4 | 93% |
| Medicare (plans) | $4 | 93% |
| Mhs | $4 | 93% |
| Node Devoted Health Mcr Adv | $4 | 93% |
| Node Hospice Non Par Agree | $4 | 93% |
| Node Mhs Mcr Adv | $4 | 93% |
| Node Pphp Mcr Adv | $4 | 93% |
| Node Va | $4 | 93% |
| One Call Work Comp | $4 | 93% |
| Physicians Health Plan | $4 - $33 | 93% |
| Police And Sheriff | $4 | 93% |
| Self Pay | $4 - $23 | 93% |
| Small Business Aid | $4 | 93% |
| Tricare | $4 | 93% |
| UnitedHealthcare | $4 - $42 | 93% |
| Cigna | $5 - $85 | 117% |
| Node Us Dept Of Labor | $5 | 117% |
| Php Freedom Network | $5 - $8 | 117% |
| Lutheran Advanced Network | $6 | 140% |
| Node Lutheran Three Rivers Preferred Plus 150 | $6 | 140% |
| Occunet In Work Comp | $6 | 140% |
| Three Rivers Preferred | $6 - $38 | 140% |
| Align Network | $7 | 163% |
| Sagamore | $7 - $46 | 163% |
| Encore Ppo | $8 - $42 | 186% |
| Encore Wc | $8 | 186% |
| Medrisk In Work Comp | $8 | 186% |
| Node Lutheran Three Rivers Preferred Plus 175 | $8 | 186% |
| Objective Surgical | $8 | 186% |
| Prime Health Services | $8 - $64 | 186% |
| Three Rivers Preferred In Work Comp | $8 | 186% |
| In Work Comp | $9 | 210% |
| Lutheran Network | $9 | 210% |
| Encore Kba Epo | $10 | 233% |
| Multiplan | $10 - $66 | 233% |
| Encore | $12 - $68 | 280% |
| First Health | $12 - $65 | 280% |
| Encore Kba Ppo | $13 | 303% |