CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: Medical Center Enterprise

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85610
  • Insurance Median: $4
  • Cash Discount Price: $80
  • vs. Medicare Baseline: 0.93x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at Medical Center Enterprise is $4. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $80. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 0.93x the Medicare baseline. Located in 400 N Edwards Street, Enterprise, AL.
Cash / Self-Pay
$80

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: $80 (1865%)
Insurance Median: $4 (93%)
Cash: $80 (1865% 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
Medicaid / KanCare $2 - $3 47%
Bc Pml $3 70%
Aetna $4 - $289 93%
Blue Cross Blue Shield $4 - $5 93%
Covenant Hospice $4 93%
Dayspring Hospice $4 93%
Eon Health $4 93%
Healthspring $4 93%
Humana $4 93%
Medicare (plans) $4 93%
Node Champva $4 93%
Node Clover Mcr Adv $4 93%
Node Devoted Health Mcr Adv $4 93%
Node Hospice Non Par $4 93%
Node Va $4 93%
Node Wellcare Mcr Adv $4 93%
Occunet $4 93%
Select Health $4 93%
Southerncare Hospice $4 93%
Tricare $4 93%
UnitedHealthcare $4 93%
Veterans Eval Services $4 93%
Wiregrass Hospice $4 93%
Al Maternity Waiver Program $5 117%
Node Us Dept Of Labor $5 117%
Ambetter / Centene $6 140%
Cigna $8 - $39 186%
Self Pay $37 - $124 862%
American Employee Alliance $165 3846%
Alamed $248 5781%
Affordable Health $289 6737%
Health Choice $289 6737%
Novanet Ppo $289 6737%
Coventry Work Comp Al $304 7086%
Multiplan $305 - $326 7110%
Wc Dept Ind Relations $330 7692%
Corvel $351 8182%
Galaxy Health $371 8648%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 400 N Edwards Street, Enterprise, AL 36330
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals