Blood test, clotting time (PT/INR)
Facility: Adventist Health Portland
Billing Code: 85610 (CPT)
- CPT Billing Code: 85610
- Insurance Median: $17
- Cash Discount Price: $27
- vs. Medicare Baseline: 3.96x 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 396% of the Medicare baseline (a markup of 296%). 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 |
|---|---|---|
| Aetna | $3 - $4 | 70% |
| Healthnet Epo/Pos/Ppo | $3 - $4 | 70% |
| Healthnet Hmo/Pos - All Other Plans | $3 - $4 | 70% |
| Ods - All Plans | $3 | 70% |
| Pacific Source Comm - All Plans | $3 - $4 | 70% |
| Providence Hp - All Plans | $3 - $4 | 70% |
| Care Oregon - All Plans | $4 | 93% |
| Humana | $4 - $5 | 93% |
| Kaiser Mcr Adv | $4 | 93% |
| Healthnet Mcr Adv | $5 | 117% |
| Moda Mcr Adv | $5 | 117% |
| UnitedHealthcare | $5 - $129 | 117% |
| Ah Employee Health Plan - All Plans | $8 | 186% |
| Moda Conn Oebb/Syn Pebb | $9 | 210% |
| Cigna | $10 | 233% |
| Moda Affinity - All Other Plans | $10 | 233% |
| Kaiser - All Other Plans | $11 | 256% |
| Regence Ohsu Plus | $11 | 256% |
| Regence - All Other Plans | $12 | 280% |
| Moda Select | $13 | 303% |
| Moda Connexus | $15 | 350% |
| Moda Synergy | $16 | 373% |
| Healthcare Resources - All Plans | $18 - $19 | 420% |
| Workers Comp | $28 - $30 | 653% |
| Bc Premera First - All Plans | $40 - $43 | 932% |
| Worldventure - All Plans | $49 - $52 | 1142% |
| Regence Preferred Mcr Adv | $53 - $56 | 1235% |
| First Choice - All Plans | $56 - $60 | 1305% |
| Multiplan - All Plans | $61 - $64 | 1422% |
| Phcs - All Plans | $61 - $64 | 1422% |
| Regence Mcr Adv | $62 - $65 | 1445% |
| First Health-Coventry - All Plans | $65 - $69 | 1515% |
| National Provider Network - All Plans | $71 - $76 | 1655% |
| Health Payors Organization Ltd- All Plans | $73 - $77 | 1702% |
| Moda Ohsu Ppo/Epo/Hmc | $146 - $155 | 3403% |