CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: Cherokee Regional Medical Center

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85610
  • Insurance Median: $42
  • Cash Discount Price: $38
  • vs. Medicare Baseline: 9.79x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at Cherokee Regional Medical Center is $42. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $38. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 9.79x the Medicare baseline. Located in 300 Sioux Valley Drive, Cherokee, IA.
Cash / Self-Pay
$38

Average discount available for prompt cash payment at this facility.

Insurance Median
$42

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: $38 (886%)
Insurance Median: $42 (979%)
Cash: $38 (886% of Medicare)
Ins. Median: $42 (979% 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 979% of the Medicare baseline (a markup of 879%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Health Partners $22 - $42 513%
Iowa Total Care $23 - $42 536%
Molina $23 - $42 536%
Admin Concepts $42 979%
Aetna $42 979%
American Republic $42 979%
Apw $42 979%
Auxiant $42 979%
Avera $42 979%
Bankers Life $42 979%
Blue Cross Blue Shield $42 979%
Champus $42 979%
Cigna $42 979%
Humana $42 979%
Liability $42 979%
Meridian $42 979%
Meritain $42 979%
Midlands $42 979%
Mutual Of Omaha $42 979%
Occunet $42 979%
Physicians Mutual $42 979%
Private Healthcare $42 979%
Sanford $42 979%
United American $42 979%
UnitedHealthcare $42 979%
Wellpoint $42 979%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 300 Sioux Valley Drive, Cherokee, IA 51012
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals