Blood test, clotting time (PT/INR)
Facility: Ascension Via Christi Rehabilitation Hospital Inc
Billing Code: 85610 (CPT)
- CPT Billing Code: 85610
- Insurance Median: $4
- Cash Discount Price: Unavailable
- 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 |
|---|---|---|
| Smarthealth | $3 - $6 | 70% |
| Humana | $4 | 93% |
| Blue Cross Blue Shield | $4 | 93% |
| Vc Hope | $4 | 93% |
| UnitedHealthcare | $4 - $12 | 93% |
| Va | $4 | 93% |
| Medicare (plans) | $4 | 93% |
| Cigna | $6 | 140% |
| Medicaid / KanCare | $7 | 163% |
| Aetna | $13 - $14 | 303% |
| Coventry City Of Wichita | $16 | 373% |
Consumer Guidance & Cost Commentary
For the blood test, clotting time (PT/INR) service at Ascension Via Christi Rehabilitation Hospital Inc in Wichita, KS, the facility's negotiated rates for major payers like UnitedHealthcare and Medicare align closely with the state average, with a negotiated rate of $4.00 compared to a Medicare benchmark of $4.29. While the facility's cash median is not listed, patients with high-deductible plans may find that paying cash directly could result in lower out-of-pocket costs if the insurance negotiated rate exceeds the cash price. It is important to note that commercial insurance rates often include administrative overhead, which can inflate the baseline price by 20% to 40% compared to the true cost of care represented by Medicare benchmarks.
Consumers should be aware that while the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, unexpected ancillary charges can still occur if specific lab components are billed separately. To ensure accuracy, patients should request a full itemized CPT-coded bill rather than accepting a summary invoice, as over 80% of hospital bills contain errors such as double-billing or unbundled codes. Additionally, patients are encouraged to ask the hospital directly about "self-pay" or "prompt-pay" discounts, which can reduce the total cost by 20% to 50% when paid in full upfront, bypassing the costly claims processing cycle that insurance billing requires.