Blood test, clotting time (PT/INR)
Facility: Prisma Health Greer Memorial Hospital
Billing Code: 85610 (CPT)
- CPT Billing Code: 85610
- Insurance Median: $23
- Cash Discount Price: $61
- vs. Medicare Baseline: 5.36x 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 536% of the Medicare baseline (a markup of 436%). 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 |
|---|---|---|
| Absolute Total Care Prime | $4 | 93% |
| Aetna | $4 - $83 | 93% |
| Blue Choice Healthplan Of Sc | $4 - $5 | 93% |
| Blue Cross Blue Shield | $4 - $55 | 93% |
| Bluechoice Healthplan Of Sc | $4 - $58 | 93% |
| Choicecare Network | $4 - $80 | 93% |
| Cigna | $4 - $75 | 93% |
| Humana | $4 - $5 | 93% |
| Liberty Advantage | $4 | 93% |
| Medicaid / KanCare | $4 - $5 | 93% |
| Medicare (plans) | $4 - $28 | 93% |
| Tricare | $4 | 93% |
| UnitedHealthcare | $4 | 93% |
| Veterans Administration | $4 | 93% |
| Windsor Health Plan | $4 | 93% |
| Molina | $5 | 117% |
| Select Health | $5 | 117% |
| Sc Workers Compensation | $6 | 140% |
| Wellpath Select Inc | $6 | 140% |
| Celtic Insurance Company | $8 | 186% |
| Prisma Health Seniorcare Pace-Upstate | $23 | 536% |
| Promise Health Plan | $47 | 1096% |
| Value Options | $47 | 1096% |
| Preferred Care, Inc | $66 | 1538% |
| Chp Direct Supermed Network | $68 | 1585% |
| Atlantic Packaging | $70 | 1632% |
| Medcost | $70 | 1632% |
| Aps Healthcare Bethesda Inc | $75 | 1748% |
| Medcost Preferred | $77 | 1795% |
| Multiplan | $84 | 1958% |
| Companion Benefit Alternatives | $94 | 2191% |
| Miscellaneous | $94 | 2191% |
| Self Pay | $94 | 2191% |