CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: Baldwin Health

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85610
  • Insurance Median: $6
  • Cash Discount Price: $58
  • vs. Medicare Baseline: 1.40x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at Baldwin Health is $6. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $58. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 1.40x the Medicare baseline. Located in 1613 North McKenzie Street, Foley, AL.
Cash / Self-Pay
$58

Average discount available for prompt cash payment at this facility.

Insurance Median
$6

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: $58 (1352%)
Insurance Median: $6 (140%)
Cash: $58 (1352% of Medicare)
Ins. Median: $6 (140% 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
First Choice $2 47%
Bc Pml $3 70%
Medicaid / KanCare $3 70%
Aetna $4 - $218 93%
Blue Cross Blue Shield $4 - $5 93%
Cigna $4 - $18 93%
Community Hospice $4 93%
Hospice $4 93%
Humana $4 93%
Medicare (plans) $4 93%
Mercy Medical Hospice $4 93%
Node Champva $4 93%
Node Clover Health Mcr Adv $4 93%
Node Devoted Health Mcr Adv $4 93%
Node Va $4 93%
Node Wellcare Mcr Adv $4 93%
Select Health $4 93%
Tricare $4 93%
Triwest $4 93%
UnitedHealthcare $4 93%
Veterans Eval Services $4 93%
Windsor Health Plan $4 93%
Us Dol $5 117%
Ambetter / Centene $6 140%
Self Pay $44 - $73 1026%
American Employee Alliance $97 2261%
Multiplan $138 - $199 3217%
First Health $182 - $196 4242%
Alamed $185 4312%
Multiplan Inc $185 4312%
Coventry Work Comp Al $189 4406%
One Health $194 4522%
Pro America $194 4522%
Novanet $196 4569%
Alabama Wc $206 4802%
Gulf Health $206 4802%
Principal Ppo $206 4802%
Viva Health $206 4802%
National Health $218 5082%
Galaxy $220 5128%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1613 North McKenzie Street, Foley, AL 36535
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals