Blood test, clotting time (PT/INR)
Facility: Lincoln County Hospital
Billing Code: 85610 (CPT)
- CPT Billing Code: 85610
- Insurance Median: $16
- Cash Discount Price: $62
- vs. Medicare Baseline: 3.73x 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 373% of the Medicare baseline (a markup of 273%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $16 | 373% |
Consumer Guidance & Cost Commentary
For the CPT code 85610, representing a blood test for clotting time (PT/INR), Lincoln County Hospital in Lincoln, KS, lists a cash median price of $62.00 and a median negotiated rate of $16.00. This cash price is notably lower than the facility's gross charge of $69.00, offering a potential savings for patients with high-deductible plans or those without insurance, as paying out-of-pocket can sometimes be cheaper than the insurance negotiated rate. While the facility is a Critical Access Hospital owned by the local government, patients should verify their specific plan details before scheduling, as the negotiated rate of $16.00 applies only to in-network insurance carriers and may not reflect the lowest possible cost for every individual.
To ensure you are receiving the most accurate pricing, it is important to request an itemized bill rather than accepting a summary invoice, as hospitals may obscure individual code costs in broad categories. If you receive a bill, review it line-by-line to check for unbundled charges or services not rendered, and dispute any errors in writing to avoid unnecessary debt. Additionally, ask the billing department about "prompt-pay" discounts, which can reduce the total amount due if you settle the bill upfront, and confirm whether your specific insurance plan has met its deductible before using the facility's services to avoid unexpected out-of-pocket expenses.