Blood test, clotting time (PT/INR)
Facility: Labette Health
Billing Code: 85610 (CPT)
- CPT Billing Code: 85610
- Insurance Median: $5
- Cash Discount Price: $26
- vs. Medicare Baseline: 1.17x 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 |
|---|---|---|
| Humana | $4 | 93% |
| Healthy Blue | $4 | 93% |
| Montgomery County | $4 - $21 | 93% |
| UnitedHealthcare | $4 - $55 | 93% |
| Wellcare | $4 | 93% |
| Medicaid / KanCare | $4 - $28 | 93% |
| Blue Cross Blue Shield | $4 - $16 | 93% |
| Uhccp | $5 | 117% |
| Ambetter / Centene | $5 - $16 | 117% |
| Multiplan | $53 | 1235% |
| Health Partners Of Kansas, Inc | $56 | 1305% |
| Choicecare (First Health Network) | $56 | 1305% |
Consumer Guidance & Cost Commentary
For the CPT code 85610, representing a blood test for clotting time (PT/INR), Labette Health in Parsons, KS, lists a cash median price of $26.00. This cash rate is notably higher than the facility's negotiated rate of $5.00, which serves as a benchmark for in-network insurance payments. While the facility is a government-owned acute care hospital, patients should be aware that commercial negotiated rates often exceed cash prices due to administrative overhead and contract structures; therefore, individuals with high-deductible plans or those without insurance may find the $26.00 cash payment more cost-effective than relying on an insurance plan that negotiates a higher allowed amount.
When comparing this service to broader regional standards, the facility's cash price aligns with the state average but exceeds the specific county average for this procedure. The Medicare benchmark for this code is set at $4.29, indicating that the cash price represents a significant markup over the federal baseline. To minimize costs, patients are encouraged to request an itemized bill before payment to verify that no unbundled charges or services not rendered are included, and to inquire about prompt-pay discounts that could further reduce the final amount owed.