Blood test, clotting time (PT/INR)
Facility: Greeley County Health Services
Billing Code: 85610 (CPT)
- CPT Billing Code: 85610
- Insurance Median: $4
- Cash Discount Price: $32
- 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 |
|---|---|---|
| Medicaid / KanCare | $4 | 93% |
| Aetna | $4 | 93% |
Consumer Guidance & Cost Commentary
For this blood clotting time test at Greeley County Health Services in Tribune, KS, the cash price of $32.00 is significantly lower than the facility's gross charge of $45.00. While the facility is a Critical Access Hospital with government ownership, the cash rate remains higher than the Medicare benchmark of $4.29, which serves as the federal baseline for true service costs. Patients with high-deductible plans or those without insurance may find the cash price more affordable than their insurance negotiated rate, which averages $4.00 for this payer group. It is important to note that while the cash rate is lower than the gross charge, it is still above the Medicare benchmark, suggesting the facility's pricing structure includes substantial markups relative to the federal standard.
To ensure you are receiving the best possible rate, we recommend requesting an itemized bill before payment to verify that no unbundled codes or services not rendered are included in the total. Although the facility offers a cash price, patients should explicitly ask about "prompt-pay" discounts, which can reduce the final amount by 20% to 50% if paid upfront, bypassing the administrative costs associated with insurance claims. Additionally, since this service is billed under CPT code 85610, please confirm with the billing department whether your specific insurance plan has a negotiated rate that exceeds the $32.00 cash price, as paying out-of-pocket might result in a higher total cost depending on your deductible status and plan terms.