Blood test, clotting time (PT/INR)
Facility: Greenwood County Hospital
Billing Code: 85610 (CPT)
- CPT Billing Code: 85610
- Insurance Median: $18
- Cash Discount Price: $34
- vs. Medicare Baseline: 4.20x 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 420% of the Medicare baseline (a markup of 320%). 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 |
|---|---|---|
| UnitedHealthcare | $3 - $57 | 70% |
| Triwest - All Plans | $6 - $24 | 140% |
| Tricare | $7 - $29 | 163% |
| Choicecare Mcr Adv - All Plans | $7 - $29 | 163% |
| Integrated Health Plan - All Plans | $13 - $51 | 303% |
| Beech Street - All Plans | $15 - $58 | 350% |
| Blue Cross Blue Shield | $15 - $16 | 350% |
| First Health Ccn Network | $15 - $58 | 350% |
| First Health - All Other Plans | $15 - $58 | 350% |
| Preferred Hs (Coventry) - All Plans | $16 - $61 | 373% |
| Principal Health Care Inc - All Plans | $17 - $65 | 396% |
| Medicaid / KanCare | $18 - $68 | 420% |
| Amerigroup Mcaid-All Plans | $18 - $68 | 420% |
| Providrs Care/Wppa - All Plans | $26 - $102 | 606% |
Consumer Guidance & Cost Commentary
For the blood clotting time test (CPT 85610) at Greenwood County Hospital in Eureka, Kansas, the cash median price is $34.00, which is lower than the facility's gross charge of $43.00. While the facility is a Critical Access Hospital owned by the local government, patients should note that commercial insurance negotiated rates often exceed cash prices due to administrative overhead and contract structures. For instance, UnitedHealthcare plans have negotiated rates ranging from $3 to $57, and Medicaid/Medicare plans range from $18 to $68, meaning paying cash upfront could result in significant savings for those with high-deductible plans or those who have already met their out-of-pocket maximum.
To minimize unexpected costs, patients should verify their specific plan's allowed amount before scheduling, as in-network rates vary widely among the 14 payers listed, with some plans allowing up to $102. If you receive a bill that includes charges for services not rendered or unbundled components, request a formal itemized audit to identify errors, as over 80% of hospital bills contain mistakes. Additionally, if you are an out-of-network patient or receive care from an out-of-network provider at this in-network facility, you may be protected from balance billing for emergency and non-emergency services under the No Surprises Act; however, you should dispute any surprise bills in writing rather than paying immediately to avoid unnecessary debt.