Blood test, clotting time (PT/INR)
Facility: Christus Southeast Texas- St Elizabeth
Billing Code: 85610 (CPT)
- CPT Billing Code: 85610
- Insurance Median: $40
- Cash Discount Price: $79
- vs. Medicare Baseline: 9.32x 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 932% of the Medicare baseline (a markup of 832%). 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 |
|---|---|---|
| Texas Healthspring | $2 | 47% |
| Aetna | $4 - $167 | 93% |
| Allwell | $4 | 93% |
| Amerigroup | $4 - $5 | 93% |
| Arcadian Health Plan | $4 | 93% |
| Blue Cross Blue Shield | $4 - $22 | 93% |
| Christus Health | $4 - $6 | 93% |
| Community Health Choice | $4 - $5 | 93% |
| Coventry | $4 | 93% |
| Humana | $4 - $12 | 93% |
| Molina | $4 | 93% |
| Provider Partners Health Plan | $4 | 93% |
| Shared Health Insurance Company | $4 | 93% |
| Superior | $4 | 93% |
| Texas Childrens Health Plan | $4 | 93% |
| Texas Independence Health Plan | $4 | 93% |
| Triwest | $4 | 93% |
| UnitedHealthcare | $4 | 93% |
| Wellcare | $4 | 93% |
| Devoted Health Plan | $5 | 117% |
| Imperial Health Plan | $5 | 117% |
| Medicare (plans) | $5 | 117% |
| Procare Advantage | $5 | 117% |
| Us Imaging Network | $5 | 117% |
| Partners Direct Health | $8 | 186% |
| Adv Cardiovas Specialist | $9 | 210% |
| Naphcare Inc. | $9 | 210% |
| Cigna | $18 - $23 | 420% |
| Healthcare Highways | $40 - $109 | 932% |
| Lsu First Choice Verity | $44 - $121 | 1026% |
| Verity Healthnet | $53 - $145 | 1235% |
| First Health | $58 - $157 | 1352% |
| Healthsmart | $58 - $194 | 1352% |
| Multiplan | $58 - $157 | 1352% |
| Phcs | $58 - $157 | 1352% |
| Five Point Credit Union | $62 - $169 | 1445% |
| Mct Credit Union | $62 - $169 | 1445% |
| Beech Street | $71 - $194 | 1655% |
| Health Management Network | $71 - $194 | 1655% |
| Provider Select | $71 - $194 | 1655% |
| Verity Healthnet National | $76 - $206 | 1772% |