Blood test, clotting time (PT/INR)
Facility: Perham Health
Billing Code: 85610 (CPT)
- CPT Billing Code: 85610
- Insurance Median: $25
- Cash Discount Price: $41
- vs. Medicare Baseline: 5.83x 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 583% of the Medicare baseline (a markup of 483%). 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 | $11 - $49 | 256% |
| Health Partners Mcr Adv | $14 - $25 | 326% |
| Humana | $14 - $25 | 326% |
| Medica Mcr Adv | $14 - $25 | 326% |
| Medicare (plans) | $14 - $28 | 326% |
| Ucare Mn Senior Health Options | $14 - $25 | 326% |
| UnitedHealthcare | $14 - $57 | 326% |
| Medica Mcaid Mn Care | $15 - $27 | 350% |
| Medicaid / KanCare | $15 - $26 | 350% |
| Ucare Mn Medical Assistance | $15 - $26 | 350% |
| Ucare Mn Minnesota Care | $15 - $26 | 350% |
| Ucare Mn Senior Care Plus | $15 - $26 | 350% |
| Ucare Mn Special Needs Basic Care | $15 - $26 | 350% |
| Ucare Mn Special Needs Basic Care Dual | $15 - $26 | 350% |
| Medica Mn (Msho) | $17 - $30 | 396% |
| Ucare Individual And Family Plan-All Other Plans | $17 - $30 | 396% |
| Medica Mn Senior Hp/Outside Mn | $19 - $33 | 443% |
| Health Partners Minnesota Care | $20 - $36 | 466% |
| Medica Commercial-All Other Plans | $30 - $53 | 699% |
| Preferred One (Pchp, Pic, Pas)-All Other Plans | $31 - $55 | 723% |
| Health Partners-All Plans | $34 - $60 | 793% |
| Preferred One (Ppo) | $35 - $62 | 816% |
| Sanford Health Plan-All Plans | $35 - $62 | 816% |