CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: Connecticut Childrens Medical Center

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85610
Insurance Median: $14
Cash Discount Price: $18
vs. Medicare Baseline: 3.26x Medicare

The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at Connecticut Childrens Medical Center is $14. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $18. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 3.26x the Medicare baseline. Located in 282 Washington Street, Hartford, CT.

Cash / Self-Pay

$18

Average discount available for prompt cash payment at this facility.

Insurance Median

$14

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: $18 (420%)

Insurance Median: $14 (326%)

Cash: $18 (420% of Medicare)

Ins. Median: $14 (326% 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 326% of the Medicare baseline (a markup of 226%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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	$5 - $36	117%
Blue Cross Blue Shield	$5 - $33	117%
Golden Rule [100106]	$5 - $36	117%
Harvard Pilgrim [1001134]	$5 - $36	117%
Oxford [100103]	$5 - $36	117%
UnitedHealthcare	$5 - $36	117%
1199 National Benefit Fund [100134]	$6 - $36	140%
Connecticare [100105]	$6 - $23	140%
Emblem Health Commercial [1001108]	$6 - $23	140%
Government Employees Hospital Assoc [100115]	$6 - $36	140%
Humana	$6 - $36	140%
Medicaid / KanCare	$6 - $23	140%
Meritain Health [100149]	$6 - $36	140%
Nippon Life Ins Co Of America [100112]	$6 - $36	140%
Yale Health Plan [100162]	$6 - $36	140%
Unicare [100148]	$7 - $33	163%
Wellpoint [100150]	$7 - $33	163%
Multiplan [1001126]	$12 - $37	280%
Cdphp/Comm [100199]	$14 - $37	326%
Cigna	$14 - $37	326%
Generic Multiplan [1001130]	$14 - $37	326%
Great West Healthcare [100107]	$14 - $37	326%
Health Partners [110229]	$14 - $37	326%
Mvp Health Plan [100144]	$14 - $37	326%
Tufts Health Plan [100114]	$14 - $37	326%
Ultrabenefits/Comm [100181]	$14 - $37	326%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $18.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 85610.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Connecticut Childrens Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 85610.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.