Blood test, clotting time (PT/INR)
Facility: Methodist Hospital
Billing Code: 85610 (CPT)
- CPT Billing Code: 85610
- Insurance Median: $33
- Cash Discount Price: $305
- vs. Medicare Baseline: 7.69x 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 769% of the Medicare baseline (a markup of 669%). 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 - $164 | 93% |
| American Health Plan Of Texas | $4 | 93% |
| Amerigroup | $4 - $46 | 93% |
| Blue Cross Blue Shield | $4 - $96 | 93% |
| Clover Insurance | $4 | 93% |
| Community First Health Plans | $4 - $88 | 93% |
| Devoted Health | $4 | 93% |
| Gonzaba Medical Group | $4 | 93% |
| Humana | $4 - $213 | 93% |
| Ilumed | $4 | 93% |
| Integranet | $4 | 93% |
| Lighthouse Hospice | $4 | 93% |
| Molina Healthcare | $4 - $7 | 93% |
| Superior Health | $4 - $16 | 93% |
| Triwest | $4 | 93% |
| Triwest Va Pccc | $4 | 93% |
| United | $4 - $147 | 93% |
| UnitedHealthcare | $4 - $327 | 93% |
| Usa Managed Care Chip | $4 | 93% |
| Wellcare | $4 | 93% |
| Wellmed | $4 | 93% |
| Texas Independent Health Plan | $5 | 117% |
| Triwest Health Alliance | $5 | 117% |
| Value Options | $5 | 117% |
| Focus Healthcare Management | $6 | 140% |
| Cigna | $7 - $95 | 163% |
| Superior | $7 | 163% |
| Focus Health Solutions | $10 | 233% |
| Healthcare Highways | $10 | 233% |
| Oscar | $11 | 256% |
| Imperial Insurance | $58 - $62 | 1352% |
| Valenz | $106 - $114 | 2471% |
| Evry Health | $111 - $120 | 2587% |
| Fidelis Securecare | $136 - $147 | 3170% |
| Emerging Therapy Solutions | $148 - $219 | 3450% |
| National Choicecare | $151 - $164 | 3520% |
| Texas Healthcare Foundation Heb | $151 - $164 | 3520% |
| Tx Healthcare Foundation | $151 - $164 | 3520% |
| Evernorth Behavioral Health | $164 | 3823% |
| Healthsmart Preferred Care | $167 - $180 | 3893% |
| Independent Medical Systems | $167 - $180 | 3893% |
| Physician Cooperative Of Texas | $167 - $180 | 3893% |
| Haa Preferred Partners | $182 - $196 | 4242% |
| San Antonio Employers Health Alliance | $182 - $196 | 4242% |
| Coastal Comp Health Networks | $197 - $213 | 4592% |
| National Healthcare Solutions | $197 - $213 | 4592% |
| Tml Intergovernmental Ebp | $212 - $229 | 4942% |
| Multiplan | $227 - $278 | 5291% |
| Blue Bell | $242 - $262 | 5641% |
| Directcare America | $242 - $262 | 5641% |
| Usa Managed Care | $242 - $262 | 5641% |
| Managed Healthcare | $257 - $278 | 5991% |