Blood test, clotting time (PT/INR)
Facility: Ascension Via Christi Hospitals Wichita, Inc.
Billing Code: 85610 (CPT)
- CPT Billing Code: 85610
- Insurance Median: $4
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.93x 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 |
|---|---|---|
| Smarthealth | $3 - $6 | 70% |
| Blue Cross Blue Shield | $4 | 93% |
| Saint Lukes Health Systems | $4 | 93% |
| UnitedHealthcare | $4 - $12 | 93% |
| Va | $4 | 93% |
| Medicare (plans) | $4 | 93% |
| Humana | $4 | 93% |
| Via Christi Research | $4 | 93% |
| Vc Hope | $4 | 93% |
| Corizon | $5 | 117% |
| Medicaid / KanCare | $7 | 163% |
| Mdsave | $9 | 210% |
| Aetna | $13 | 303% |
| Coventry City Of Wichita | $16 | 373% |
Consumer Guidance & Cost Commentary
For the blood test, clotting time (PT/INR) procedure at Ascension Via Christi Hospitals Wichita, Inc., the facility's negotiated rates range from $3 to $16 depending on the insurance plan, with a median negotiated amount of $4.00. This facility is located in Wichita, Kansas, and serves 14 different payers, including major carriers like UnitedHealthcare, Blue Cross Blue Shield, and Medicare. While the data does not provide a specific cash or median paid amount for this service, patients should be aware that cash-pay options can sometimes result in lower out-of-pocket costs if their insurance negotiated rate exceeds the cash price. To secure the best possible rate, it is recommended to contact the hospital directly to inquire about "self-pay" or "prompt-pay" discounts, which can significantly reduce the final bill for those paying upfront.
When reviewing your bill, it is important to distinguish between the facility's negotiated rates and the federal Medicare benchmark, which stands at $4.29 for this code. The facility's median negotiated rate of $4.00 is slightly lower than the Medicare amount, indicating a competitive pricing structure relative to the federal baseline. However, if you are billed for services from out-of-network providers at this in-network facility, you may encounter balance billing, where you are charged the difference between the provider's full list price and what your insurance pays. Under the No Surprises Act, balance billing is generally prohibited for emergency care and non-emergency services at in-network facilities, so any unexpected charges should be disputed in writing with the insurer. Additionally, if you receive a summary bill, request a full itemized audit to ensure no unbundled codes or services not rendered have