CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: Athur M Blank Hospital

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85610
Insurance Median: $135
Cash Discount Price: $197
vs. Medicare Baseline: 31.47x Medicare

The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at Athur M Blank Hospital is $135. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $197. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 31.47x the Medicare baseline. Located in 2220 North Druid Hills Road Ne, Atlanta, GA.

Cash / Self-Pay

$197

Average discount available for prompt cash payment at this facility.

Insurance Median

$135

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: $197 (4592%)

Insurance Median: $135 (3147%)

Cash: $197 (4592% of Medicare)

Ins. Median: $135 (3147% 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 3147% of the Medicare baseline (a markup of 3047%). 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
Amerigroup [102]	$6	140%
Caresource [61]	$6	140%
Peachstate [43]	$6	140%
Blue Cross Blue Shield	$86 - $215	2005%
Cigna	$86 - $145	2005%
United [5]	$86 - $146	2005%
Aetna	$87 - $148	2028%
Ambetter / Centene	$87 - $147	2028%
Oscar [228]	$87 - $147	2028%
Caresource Marketplace Bronze/Silver/Gold [60]	$88 - $149	2051%
Kaiser [6]	$89 - $150	2075%
Sidecar Health [236]	$90 - $152	2098%
Coventry [9]	$91 - $154	2121%
Direct Employer Agreements [72]	$91 - $187	2121%
First Health [74]	$98 - $165	2284%
Northeast Georgia Heatlh System [808]	$98 - $165	2284%
Veracity Benefits [809]	$98 - $165	2284%
Phcs [93]	$110 - $187	2564%
Secure Health [340]	$110 - $187	2564%
Beech Street [71]	$117 - $198	2727%
Multiplan [92]	$127 - $216	2960%
Novanet [41]	$130 - $220	3030%

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 $197.
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 Athur M Blank Hospital 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.