Blood test, clotting time (PT/INR)
Facility: Memorial Medical Center
Billing Code: 85610 (CPT)
- CPT Billing Code: 85610
- Insurance Median: $42
- Cash Discount Price: $55
- vs. Medicare Baseline: 9.79x 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 979% of the Medicare baseline (a markup of 879%). 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 |
|---|---|---|
| Amerigroup Mcr Adv-All Other Plans | $15 - $29 | 350% |
| Care Improvement Plus - All Other Plans | $15 - $29 | 350% |
| Care Improvement Plus Mcr | $15 - $29 | 350% |
| Coventry First Hlth Mcr Adv | $15 - $29 | 350% |
| Multiplan Mcr Adv | $15 - $29 | 350% |
| Superior Allwell Mcr Adv-All Other Plans | $15 - $29 | 350% |
| Triwest Va Pccc-All Plans | $15 - $28 | 350% |
| UnitedHealthcare | $15 - $82 | 350% |
| Universal American Mcr-All Other Plans | $15 - $29 | 350% |
| Universal American Snp | $16 - $30 | 373% |
| Ambetter / Centene | $18 - $35 | 420% |
| Blue Cross Blue Shield | $19 - $20 | 443% |
| Amerigroup Chip | $26 - $49 | 606% |
| Amerigroup Star | $26 - $49 | 606% |
| Amerigroup Star Kids | $26 - $49 | 606% |
| Amerigroup Star Plus | $26 - $49 | 606% |
| Comm Health Chip | $26 - $49 | 606% |
| Comm Health Perinatal-All Other Plans | $26 - $49 | 606% |
| Molina Chip/Star-All Plans | $26 - $49 | 606% |
| Scott & White Chip/Star-All Plans | $26 - $49 | 606% |
| Superior Chip/Star | $26 - $49 | 606% |
| Texas Childrens Hp - All Plans | $26 - $49 | 606% |
| Comm Health Mcaid Hmo | $27 - $52 | 629% |
| Comm Health Star | $27 - $52 | 629% |
| Prime Healthcare Services-All Plans | $38 - $72 | 886% |
| Cigna | $40 - $77 | 932% |
| Aetna | $43 - $82 | 1002% |
| Capstar Health Network-All Plans | $43 - $82 | 1002% |
| Coventry First Hlth Hmo Ppo-All Other Plans | $43 - $82 | 1002% |
| Healthcare Highways-All Plans | $43 - $82 | 1002% |
| Humana | $43 - $82 | 1002% |
| Corvel Work Comp-All Plans | $46 - $88 | 1072% |
| Galaxy Health Network-All Plans | $46 - $88 | 1072% |
| Independent Med Sys Ppo-All Plans | $46 - $88 | 1072% |
| Multiplan Phcs Ppo-All Other Plans | $46 - $88 | 1072% |
| Provider Select Ppo-All Plans | $46 - $88 | 1072% |
| Three Rivers Ppo-All Plans | $46 - $88 | 1072% |
| Usa Mso - All Plans | $46 - $88 | 1072% |