CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: Medical City Lewisville

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85610
  • Insurance Median: $6
  • Cash Discount Price: $760
  • vs. Medicare Baseline: 1.40x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at Medical City Lewisville is $6. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $760. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 1.40x the Medicare baseline. Located in 500 West Main Street, Lewisville, TX.
Cash / Self-Pay
$760

Average discount available for prompt cash payment at this facility.

Insurance Median
$6

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$4.29

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $4.29 (100%)
Cash / Self-Pay: $760 (17716%)
Insurance Median: $6 (140%)
Cash: $760 (17716% of Medicare)
Ins. Median: $6 (140% of 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.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Cook Childrens Health Plan $3 70%
Aetna $4 - $553 93%
American Health Plan Of Texas, Inc. $4 93%
Amerigroup $4 93%
Blue Cross Blue Shield $4 - $338 93%
Care N Care $4 93%
Cigna $4 - $106 93%
Devoted Health $4 93%
Humana $4 - $44 93%
Integranet $4 93%
Molina $4 - $5 93%
Mutual Of Omaha $4 93%
Parkland Community Health Plan $4 93%
Procare Advantge $4 93%
Superior Health Plan $4 - $53 93%
Texas Health Network $4 93%
Triwest Health Alliance $4 93%
United $4 - $151 93%
Wellcare $4 93%
Wellmed $4 93%
Imperial Insurance Company $5 117%
Provider Partners Health Plan $5 117%
Texas Independent Health Plan $5 117%
Universal Healthcare Group $5 117%
Bravo Health $6 140%
Verda Health Plan $6 140%
Corvel Corporation $8 186%
Superior $8 - $10 186%
Usa Managed Care $8 - $608 186%
Molina Healthcare $11 256%
Oscar $11 256%
Unicare $182 - $760 4242%
Healthcare Highways $186 - $257 4336%
Evry Health $196 4569%
City Of Mckinney $342 7972%
Fidelis Securecare $342 7972%
National Choicecare $380 8858%
Pc Texas Partners $418 9744%
Physicians Coop Of Tx $418 9744%
Rockport Health Group $418 9744%
Averde Health, Inc $441 10280%
Usc Health Services $456 10629%
Coastal Comp Health Networks $532 12401%
Jostens $532 12401%
Mega Life $532 12401%
Multiplan Phcs $532 12401%
Healthsmart Preferred Care $570 13287%
Lewisville Isd/Dls Consulting $570 13287%
Galaxy Health Network $646 15058%
Independent Medical Systems $760 17716%
National Healthcare Solutions $760 17716%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 500 West Main Street, Lewisville, TX 75057
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals