CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: The East Alabama Healthcare Authority

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85610
  • Insurance Median: $44
  • Cash Discount Price: $44
  • vs. Medicare Baseline: 10.26x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at The East Alabama Healthcare Authority is $44. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $44. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 10.26x the Medicare baseline. Located in 2000 Pepperell Parkway, Opelika, AL.
Cash / Self-Pay
$44

Average discount available for prompt cash payment at this facility.

Insurance Median
$44

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: $44 (1026%)
Insurance Median: $44 (1026%)
Cash: $44 (1026% of Medicare)
Ins. Median: $44 (1026% 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 1026% of the Medicare baseline (a markup of 926%). 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 - $80 93%
Beechstreet $4 - $68 93%
Blue Cross Blue Shield $4 - $6 93%
Cigna $4 - $8 93%
Humana $4 - $56 93%
Simpra $4 93%
Viva $4 - $10 93%
Novanet $12 280%
Alabama Crime Victims $40 932%
Mcm Maxcare $64 1492%
Mega Life $64 1492%
UnitedHealthcare $64 1492%
Coventry First Health $68 1585%
Geha $68 1585%
Multiplan $68 1585%
Workers Comp $68 1585%
Trpn $72 1678%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2000 Pepperell Parkway, Opelika, AL 36801
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals