Blood test, clotting time (PT/INR)
Facility: Dukes Memorial Hospital
Billing Code: 85610 (CPT)
- CPT Billing Code: 85610
- Insurance Median: $11
- Cash Discount Price: $12
- vs. Medicare Baseline: 2.56x 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 256% of the Medicare baseline (a markup of 156%). 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 |
|---|---|---|
| Aetna | $1 - $53 | 23% |
| Blue Cross Blue Shield | $1 - $36 | 23% |
| Department Of Veterans Affairs | $1 - $21 | 23% |
| Humana | $1 - $22 | 23% |
| In Dept Of Correction | $1 - $23 | 23% |
| Iu Health Plan | $1 - $22 | 23% |
| Managed Health Services | $1 - $45 | 23% |
| Medicare (plans) | $1 - $22 | 23% |
| Miami County Sheriffs Department | $1 - $23 | 23% |
| Node Devoted Health Mcr Adv | $1 - $22 | 23% |
| Node Pphp Mcr Adv | $1 - $24 | 23% |
| Node Va | $1 - $54 | 23% |
| Tricare | $1 - $21 | 23% |
| UnitedHealthcare | $1 - $55 | 23% |
| Align Network | $2 - $36 | 47% |
| Cigna | $2 - $112 | 47% |
| Encore Work Comp In | $2 - $40 | 47% |
| Lutheran Advanced Network | $2 - $34 | 47% |
| Lutheran Northwest Health Preferred | $2 - $45 | 47% |
| Lutheran Preferred | $2 - $90 | 47% |
| Lutheran Three Rivers Preferred Plus 150 | $2 - $34 | 47% |
| Lutheran Three Rivers Preferred Plus 175 | $2 - $39 | 47% |
| Node Lutheran Preferred Fixed 2 | $2 - $34 | 47% |
| Partners Direct Health Llc | $2 - $43 | 47% |
| Physicians Health Plan | $2 - $52 | 47% |
| Prime Health Services | $2 - $84 | 47% |
| Three Rivers Preferred | $2 - $50 | 47% |
| Three Rivers Preferred Plus | $2 - $45 | 47% |
| Work Comp | $2 - $45 | 47% |
| Amish Aid | $3 - $56 | 70% |
| Consumer Life | $3 - $69 | 70% |
| Encore Kba Epo | $3 - $54 | 70% |
| Encore Kba Ppo | $3 - $67 | 70% |
| Encore Ppo | $3 - $56 | 70% |
| Php Freedom | $3 - $52 | 70% |
| Sagamore Health Network | $3 - $62 | 70% |
| Self Pay | $3 - $62 | 70% |
| Caresource | $4 | 93% |
| Encore Health Network | $4 - $92 | 93% |
| First Health | $4 - $90 | 93% |
| Medicaid / KanCare | $4 | 93% |
| Mhs | $4 | 93% |
| Multiplan | $4 - $91 | 93% |
| Veterans Eval Services | $4 | 93% |
| Advantage Health Solutions | $5 - $93 | 117% |
| Encore | $5 - $101 | 117% |
| Us Department Of Labor | $5 | 117% |