CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: Intermountain Health Heber Valley Hospital

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85610
  • Insurance Median: $30
  • Cash Discount Price: $47
  • vs. Medicare Baseline: 6.99x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at Intermountain Health Heber Valley Hospital is $30. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $47. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 6.99x the Medicare baseline. Located in 454 East Medical Way, Heber City, UT.
Cash / Self-Pay
$47

Average discount available for prompt cash payment at this facility.

Insurance Median
$30

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: $47 (1096%)
Insurance Median: $30 (699%)
Cash: $47 (1096% of Medicare)
Ins. Median: $30 (699% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 699% of the Medicare baseline (a markup of 599%). 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.

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
Aetna $4 - $88 93%
American Health $4 - $30 93%
Blue Cross Blue Shield $4 - $89 93%
Health Partners Of Nevada $4 - $30 93%
Health Plan Of Nevada $4 - $89 93%
Healthy U $4 - $89 93%
Humana $4 - $30 93%
Molina $4 - $89 93%
Selecthealth $4 - $89 93%
UnitedHealthcare $4 - $89 93%
Triwest $9 - $76 210%
Corporation Of The President $20 - $75 466%
Corvel Corporation $20 - $75 466%
Injury Care Of Nevada $20 - $75 466%
Wcf Insurance $20 - $75 466%
Byu Risk Management $22 - $85 513%
Cigna $22 - $89 513%
Medcare International $22 - $85 513%
Springtide $22 - $85 513%
Uofu $22 - $85 513%
Awh Connected $23 - $90 536%
Byu Athletics $23 - $87 536%
Campbell Scientific $23 - $87 536%
Deseret Mutual $23 - $89 536%
Emi $23 - $89 536%
Emi Health $23 - $87 536%
Franklin County $23 - $87 536%
Global Excel $23 - $90 536%
Health Utah $23 - $90 536%
Hygeia Corporation $23 - $90 536%
Ifit $23 - $87 536%
Intermountain Caregiver Plan $23 - $89 536%
Juniper Systems $23 - $87 536%
Lw Miller $23 - $87 536%
Managed Care Admin $23 - $87 536%
Motivhealth $23 - $87 536%
Pehp $23 - $90 536%
Prodegi Corp Benefit $23 - $87 536%
Tanner Llc $23 - $87 536%
Utah Tech $23 - $87 536%
Wise Network $23 - $87 536%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 454 East Medical Way, Heber City, UT 84032
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals