Blood test, clotting time (PT/INR)
Facility: Pratt Regional Medical Center
Billing Code: 85610 (CPT)
- CPT Billing Code: 85610
- Insurance Median: $43
- Cash Discount Price: $34
- vs. Medicare Baseline: 10.02x 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 1002% of the Medicare baseline (a markup of 902%). 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 |
|---|---|---|
| Christian Health Aid | $32 - $76 | 746% |
| UnitedHealthcare | $35 - $103 | 816% |
| Health Partners Of Kansas | $36 - $86 | 839% |
| Aetna | $38 - $91 | 886% |
| Choicecare | $42 - $101 | 979% |
Consumer Guidance & Cost Commentary
For the blood clotting time test (CPT 85610) at Pratt Regional Medical Center in Pratt, KS, the facility's cash median price of $34.00 is notably lower than the state average, which sits at $48.00. While the gross chargemaster lists the procedure at $48.00, patients with high-deductible plans or those seeking to minimize out-of-pocket costs may find the cash rate more advantageous than the negotiated rates paid by insurers. The facility's negotiated rates range from $32 to $103 across five payers, with the lowest allowed amount being $32.00 for Christian Health Aid. Because insurance processing often includes administrative overhead and potential deductibles, paying the cash price directly can sometimes result in a lower total cost, provided the patient's insurance allowed amount exceeds $34.00.
To secure the best possible price, patients should proactively request "self-pay" or "prompt-pay" discounts before scheduling their visit, as these upfront payment incentives can further reduce the bill by bypassing standard insurance billing cycles. It is important to note that while the facility is in-network for the listed payers, balance billing could still occur if ancillary services or specific lab components are rendered out-of-network, though the No Surprises Act offers protections for emergency and non-emergency care at in-network facilities. For transparency, the facility's rating is 4 out of 5, and the Medicare benchmark for this service is $4.29, which serves as a baseline to evaluate the facility's pricing markup relative to federal standards.