CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: Lovelace Medical Center

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85610
Insurance Median: $226
Cash Discount Price: $75
vs. Medicare Baseline: 52.68x Medicare

The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at Lovelace Medical Center is $226. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $75. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 52.68x the Medicare baseline. Located in 601 Dr Martin Luther King Jr Ave Ne, Albuquerque, NM.

Cash / Self-Pay

$75

Average discount available for prompt cash payment at this facility.

Insurance Median

$226

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$4.29

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $4.29 (100%)

Cash / Self-Pay: $75 (1748%)

Insurance Median: $226 (5268%)

Cash: $75 (1748% of Medicare)

Ins. Median: $226 (5268% of 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 5268% of the Medicare baseline (a markup of 5168%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
The Health Plan [2915]	$51	1189%
Healthscope Benefits [2290]	$64	1492%
UnitedHealthcare	$64	1492%
Benefit Management [1175]	$126	2937%
Magellan Behavioral Commercial [2895]	$126	2937%
Presbyterian Health Plan [1830]	$126	2937%
Zelis [2385]	$126	2937%
Administrative Concepts [1005]	$226	5268%
Aetna	$226	5268%
Allied Benefit Systems Inc [1030]	$226	5268%
Allied National Global Care [1035]	$226	5268%
American Medical Security [2190]	$226	5268%
Boon-Chapman [2375]	$226	5268%
Coresource [1315]	$226	5268%
Coventry Healthcare [1320]	$226	5268%
Emblem Health [2430]	$226	5268%
Employee Benefit Management Services [2445]	$226	5268%
Healthcost Solutions [2415]	$226	5268%
Multiplan [1680]	$226	5268%
Mutual Of Omaha [1685]	$226	5268%
National Telephone Cooperative [1700]	$226	5268%
Northamerica Administrators [1725]	$226	5268%
Pan American Life Insurance Co [1770]	$226	5268%
Phcs [1780]	$226	5268%
Trustmark [2030]	$226	5268%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $75.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 85610.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Lovelace Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 85610.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.