Blood test, clotting time (PT/INR)
Facility: Logan County Hospital
Billing Code: 85610 (CPT)
- CPT Billing Code: 85610
- Insurance Median: $25
- Cash Discount Price: $7
- vs. Medicare Baseline: 5.83x 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 583% of the Medicare baseline (a markup of 483%). 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 |
|---|---|---|
| Humana | $15 | 350% |
| Blue Cross Blue Shield | $16 | 373% |
| Health Partners - All Plans | $33 | 769% |
| Medicaid / KanCare | $35 | 816% |
Consumer Guidance & Cost Commentary
For the CPT code 85610, representing a blood test for clotting time, Logan County Hospital in Oakley, KS, lists a gross charge of $35.00. This amount is significantly higher than the state average, which is $7.00, and exceeds the Medicare benchmark of $4.29 by a factor of over eight times. While the facility's median negotiated rate for commercial payers is $25.00, this figure remains well above the cash price of $7.00. Patients with high-deductible plans or those without insurance may find it financially advantageous to pay the cash price directly, as the negotiated rates often include administrative overhead that inflates the cost for insured members.
To minimize out-of-pocket expenses, consumers should verify if the hospital offers "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% for upfront payment. It is also important to note that while the facility is in-network for four major payers, the specific allowed amount varies by plan, with rates ranging from $15.00 to $35.00 depending on the carrier. Since over 80% of hospital bills contain errors, patients are encouraged to request a detailed, itemized statement before paying to ensure no duplicate charges or unbundled codes are included. Always confirm your deductible status and ask for a waiver of insurance submission if you choose to pay cash to avoid automatic claims processing that could void any potential discounts.