Blood test, clotting time (PT/INR)
Facility: Kearny County Hospital
Billing Code: 85610 (CPT)
- CPT Billing Code: 85610
- Insurance Median: $49
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 11.42x 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 1142% of the Medicare baseline (a markup of 1042%). 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 |
|---|---|---|
| Meritain Health | $49 | 1142% |
| Blue Cross Blue Shield | $49 | 1142% |
| Wps Gha - Mac J5 Part A | $49 | 1142% |
| Aetna | $49 | 1142% |
| UnitedHealthcare | $49 | 1142% |
| Humana | $49 | 1142% |
| Community Care Health Plan Of | $49 | 1142% |
| Kansas Solutions | $49 | 1142% |
Consumer Guidance & Cost Commentary
For the blood clotting time test (CPT 85610) at Kearny County Hospital in Lakin, KS, the facility's negotiated rate of $49.00 aligns exactly with the highest and lowest amounts reported across all eight insurance payers, including Meritain Health, UnitedHealthcare, and Humana. This consistency suggests that the hospital has a uniform contract structure with these insurers, resulting in a single allowed amount of $49.00 for each plan. While the facility is a government-owned Critical Access Hospital, the negotiated rate is significantly higher than the Medicare benchmark of $4.29, reflecting the standard commercial markup where in-network rates often average 200% to 300% of the federal baseline. For patients with high-deductible plans, this difference is notable: if your deductible has not yet been met, you may be responsible for the full $49.00, whereas paying cash directly could result in a lower out-of-pocket cost, as cash prices are frequently lower than insurance negotiated rates.
It is important to verify your specific plan details before scheduling, as assuming that being in-network guarantees the lowest possible price can lead to unexpected costs. Although the data shows a uniform $49.00 allowed amount for all listed payers, individual plan deductibles and copays will determine your actual financial responsibility. If you are concerned about the total bill, you should contact the hospital directly to inquire about "self-pay" or "prompt-pay" discounts, which can reduce the balance by 20% to 50% if paid in full upfront. Additionally, since over 80% of hospital bills contain errors, we recommend