CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: Gadsden Regional Medical Center

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85610
  • Insurance Median: $4
  • Cash Discount Price: $117
  • vs. Medicare Baseline: 0.93x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at Gadsden Regional Medical Center is $4. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $117. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 0.93x the Medicare baseline. Located in 1007 Goodyear Avenue, Gadsden, AL.
Cash / Self-Pay
$117

Average discount available for prompt cash payment at this facility.

Insurance Median
$4

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: $117 (2727%)
Insurance Median: $4 (93%)
Cash: $117 (2727% of Medicare)
Ins. Median: $4 (93% 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
Bc Pml $3 70%
Medicaid / KanCare $3 70%
Aetna $4 - $403 93%
Amedisys Hospice $4 93%
Blue Cross Blue Shield $4 93%
Cigna $4 - $27 93%
Gadsden Hospice $4 93%
Humana $4 93%
Medicare (plans) $4 93%
Node Champva $4 93%
Node Clover Health Mcr Adv $4 93%
Node Devoted Health Mcr Adv $4 93%
Node Eon Mcr Adv $4 93%
Node Non Par Hospice Agree $4 93%
Node Select Health Mcr Adv $4 93%
Node Va $4 93%
Node Viva Mcr Adv $4 93%
Node Wellcare Mcr Adv $4 93%
Prime Health $4 - $563 93%
Southern Care Hospice $4 93%
Tricare $4 93%
UnitedHealthcare $4 93%
Veterans Eval Services $4 93%
Node Us Dept Of Labor $5 117%
Ambetter / Centene $6 140%
Self Pay $93 - $140 2168%
American Employee Alliance $311 7249%
Multiplan $436 - $491 10163%
Magellan Behavioral $467 10886%
Viva Healthcare $467 10886%
First Health $545 - $629 12704%
Beech Street $568 - $1,525 13240%
Alamed Wc $584 13613%
Focus Health $596 13893%
Coventry Work Comp Al $609 14196%
Work Comp $662 15431%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1007 Goodyear Avenue, Gadsden, AL 35903
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals