Blood test, clotting time (PT/INR)
Facility: Quail Creek Surgical Hospital
Billing Code: 85610 (CPT)
- CPT Billing Code: 85610
- Insurance Median: $29
- Cash Discount Price: $21
- vs. Medicare Baseline: 6.76x 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 676% of the Medicare baseline (a markup of 576%). 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 |
|---|---|---|
| First Care Commercial [1371] | $13 | 303% |
| Healthscope Benefits [2290] | $14 - $16 | 326% |
| UnitedHealthcare | $14 - $31 | 326% |
| Insurance Management Services (Ims) [1540] | $15 - $19 | 350% |
| Aetna | $16 - $32 | 373% |
| Amerigroup Commercial [5055] | $16 | 373% |
| Black Lung [6055] | $16 | 373% |
| Caprock Health Plans [1200] | $16 | 373% |
| Cigna | $16 - $30 | 373% |
| Curative [7085] | $16 | 373% |
| Healthcare Highways [2210] | $16 | 373% |
| Horizon Nj Health [3635] | $16 | 373% |
| Lucent Health [6000] | $16 | 373% |
| Medicaid / KanCare | $16 | 373% |
| Midland Pace Mcaid [3715] | $16 | 373% |
| Oncology Patient Assistance Programs [2295] | $16 | 373% |
| Texas Childrens Health Plan [3995] | $16 | 373% |
| Web Tpa [2115] | $16 - $32 | 373% |
| Maxor Insurance [1610] | $20 | 466% |
| American Healthcare [1055] | $21 | 490% |
| Group Pension Admin [1450] | $21 | 490% |
| Sana Benefits [5005] | $21 | 490% |
| Texas Rehab [1965] | $24 | 559% |
| Texas Rehabilitation [1970] | $24 | 559% |
| Nreca [1735] | $26 | 606% |
| Tml [1980] | $26 | 606% |
| United Behavioral Health [3820] | $26 | 606% |
| Administrative Concepts [1005] | $29 | 676% |
| Alieracare [2935] | $29 | 676% |
| Americas Choice Health Plans [1090] | $29 | 676% |
| Assurant Health [1105] | $29 - $32 | 676% |
| Beech Street [1170] | $29 | 676% |
| Benefit Management [1175] | $29 | 676% |
| Cbsa [1215] | $29 | 676% |
| Celtic Life [1220] | $29 | 676% |
| Cherokee Insurance [1245] | $29 | 676% |
| Comcar Industries [1280] | $29 | 676% |
| Equitable [1355] | $29 | 676% |
| Federated Mutual [1365] | $29 | 676% |
| Ge Group Administrators [1405] | $29 | 676% |
| Guardian [1465] | $29 | 676% |
| Insurers Administrative Corp [1550] | $29 | 676% |
| Lewer Agency [1565] | $29 | 676% |
| Medica [2910] | $29 | 676% |
| Medishare Christian Care [1645] | $29 | 676% |
| Mega Life And Health [1650] | $29 | 676% |
| Northamerica Administrators [1725] | $29 | 676% |
| Pan American Life Insurance Co [1770] | $29 | 676% |
| Phcs [1780] | $29 | 676% |
| Phoenix Home Life [1785] | $29 | 676% |
| Principal Mutual Life [1845] | $29 | 676% |
| Rh Administrators [1885] | $29 | 676% |
| Trustmark [2030] | $29 - $32 | 676% |
| Coresource [1315] | $30 | 699% |
| Healthpartners [1500] | $30 | 699% |
| National Association Of Letter Carriers [1695] | $30 | 699% |
| Allied Benefit Systems Inc [1030] | $32 | 746% |
| American Veterinary [1085] | $32 | 746% |
| Cba Administrators [1210] | $32 | 746% |
| Coventry Healthcare [1320] | $32 | 746% |
| Fmh Benefit Services [1390] | $32 | 746% |
| Gilsbar [1425] | $32 | 746% |
| Healthnet [1495] | $32 | 746% |
| Mailhandlers [1595] | $32 | 746% |
| Meritain Health [1655] | $32 | 746% |
| Reserve National [1880] | $32 | 746% |
| Rural Carrier Benefit Plan [1895] | $32 | 746% |
| Allied National Global Care [1035] | $36 | 839% |
| Combined Insurance Of America [1275] | $36 | 839% |
| Freedom Life Insurance [1400] | $36 | 839% |
| Group Health [2165] | $36 | 839% |
| Kaiser Permanente [1560] | $36 | 839% |
| Multiplan [1680] | $36 | 839% |
| Mutual Of Omaha [1685] | $36 | 839% |
| New Era Life Insurance Company [1705] | $36 | 839% |
| Pba [1775] | $36 | 839% |
| Planned Administrators Inc [2360] | $36 | 839% |
| Universal Fidelity [2085] | $36 | 839% |