Blood test, clotting time (PT/INR)
Facility: Rehabilitation Hospital Of Overland Park
Billing Code: 85610 (CPT)
- CPT Billing Code: 85610
- Insurance Median: $93
- Cash Discount Price: $125
- vs. Medicare Baseline: 21.68x 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 2168% of the Medicare baseline (a markup of 2068%). 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 | $75 | 1748% |
| Americas Choice Provider Network | $87 | 2028% |
| Usa Managed Care Organization | $93 | 2168% |
| Velocity | $93 | 2168% |
| Provider Network Of America | $93 | 2168% |
| Quiktrip Corporation | $93 | 2168% |
| Multiplan-Phcs | $100 | 2331% |
| Prime Health Services | $106 | 2471% |
| Medincrease | $112 | 2611% |
Consumer Guidance & Cost Commentary
For the blood clotting time test (CPT 85610) at the Rehabilitation Hospital Of Overland Park, the cash price is $125.00, which matches the facility's negotiated rate of $93.00 across nine payers. This cash rate is significantly higher than the state average, as indicated by a 21.7% variance above the Medicare benchmark of $4.29. While commercial insurance contracts typically range from 200% to 300% of the Medicare rate, the facility's negotiated ceiling of $93.00 remains above the Medicare baseline, suggesting that for patients with high-deductible plans, paying the full cash price of $125.00 upfront could result in lower out-of-pocket costs compared to insurance claims that may exceed this amount before deductibles are met.
Patients should verify their specific plan details before scheduling, as assuming in-network status guarantees the lowest price is a common pitfall; some in-network facilities charge substantially more than others for the same service. If you choose to pay out-of-pocket, ask the billing department about "self-pay" or "prompt-pay" discounts, which can reduce the $125.00 charge by 20% to 50% if paid in full within 30 days. Additionally, always request an itemized bill before finalizing payment to ensure no errors, double-billing, or unbundled charges are included, as over 80% of hospital bills contain mistakes that can be corrected through a formal written audit dispute.