Blood test, clotting time (PT/INR)
Facility: Lancaster General Hospital
Billing Code: 85610 (CPT)
- CPT Billing Code: 85610
- Insurance Median: $17
- Cash Discount Price: $29
- 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 | $4 - $19 | 93% |
| Albright Life | $4 | 93% |
| Amerihealth Caritas | $4 | 93% |
| Blue Cross Blue Shield | $4 - $25 | 93% |
| Cigna | $4 - $24 | 93% |
| Coatesville Va | $4 | 93% |
| Devoted Health | $4 | 93% |
| Health Partners Mcr Advantage | $4 | 93% |
| Highmark | $4 - $29 | 93% |
| Hospice Generic | $4 | 93% |
| Lancaster County Mh | $4 | 93% |
| Lebanon Veterans Hospital | $4 | 93% |
| Medicaid / KanCare | $4 - $8 | 93% |
| Medicare (plans) | $4 - $5 | 93% |
| Pa Health And Wellness Mcr | $4 | 93% |
| Tricare | $4 | 93% |
| UnitedHealthcare | $4 - $25 | 93% |
| Gateway | $5 | 117% |
| Hospice And Community Care | $5 - $6 | 117% |
| Elap Employees | $6 | 140% |
| Upmc For You | $7 | 163% |
| Lancashire Hall | $8 - $29 | 186% |
| Lg Coresource/Lg Eliance | $8 | 186% |
| Nursing Home Op Services | $8 - $9 | 186% |
| Old Order Group | $8 - $9 | 186% |
| Oscar Health Plan | $8 | 186% |
| Highmark Commercial Preferred | $9 - $29 | 210% |
| Affilia Home Health | $11 - $29 | 256% |
| Masonic Homes | $12 - $29 | 280% |
| Claim Watcher Plus | $13 | 303% |
| Eliance Health Solutions | $13 - $19 | 303% |
| Highmark Commercial Non-Preferred | $13 - $29 | 303% |
| Claim Watcher | $14 | 326% |
| Elap Other Groups | $16 | 373% |
| Preferred Healthcare | $17 - $25 | 396% |
| Ehp | $23 - $24 | 536% |
| Upmc Commercial | $23 - $25 | 536% |
| Devon | $24 - $25 | 559% |
| Geisinger Commercial | $24 - $25 | 559% |
| Intergroup Services | $24 - $25 | 559% |
| Medi-Share Christian Care | $27 - $28 | 629% |
| Commercial Generic | $28 - $29 | 653% |
| Magellan | $28 - $29 | 653% |
| United Behavioral Health | $28 - $29 | 653% |
| Value Options | $28 - $29 | 653% |
| Workers Compensation | $28 - $29 | 653% |
| Gift Of Life Donor Program | $13,500 | 314685% |