Blood test, clotting time (PT/INR)
Facility: Kingman Healthcare Center
Billing Code: 85610 (CPT)
- CPT Billing Code: 85610
- Insurance Median: $7
- Cash Discount Price: $6
- vs. Medicare Baseline: 1.63x 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 |
|---|---|---|
| UnitedHealthcare | $1 - $34 | 23% |
| Health Partners | $1 - $34 | 23% |
| Cigna | $1 - $34 | 23% |
| Aetna | $1 - $34 | 23% |
| Healthy Blue | $4 | 93% |
| Medicaid / KanCare | $4 - $17 | 93% |
| Humana | $4 - $15 | 93% |
| Wellcare | $4 - $15 | 93% |
| Ambetter / Centene | $4 - $17 | 93% |
| Triwest | $4 | 93% |
| Celtic Insurance Company | $4 - $17 | 93% |
Consumer Guidance & Cost Commentary
For the CPT code 85610, representing a blood test for clotting time (PT/INR), Kingman Healthcare Center in Kingman, KS, lists a cash median price of $6.00. This cash rate is notably lower than the facility's negotiated rates, which average $7.00 across various payers, and significantly below the gross charge of $9.00. While commercial insurance contracts typically cap payments at negotiated rates, patients with high-deductible plans may find the cash price more advantageous if their insurance negotiated rate exceeds $6.00. It is important to note that the facility's cash median of $6.00 is lower than the state average for this service, offering a potential cost-saving option for those paying directly.
To ensure you are receiving the most favorable rate, we recommend requesting an itemized billing audit before finalizing payment, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. Additionally, ask the billing department about "prompt-pay" discounts, which can reduce the final amount by 20% to 50% for upfront payment, effectively bypassing the administrative costs associated with insurance claims processing. Since this service is covered under the No Surprises Act for emergency care and non-emergency services at in-network facilities, you should also verify that no balance billing will occur if you choose to pay out-of-network, ensuring you avoid unexpected charges beyond the negotiated or cash rates.