CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: Eastern Idaho Regional Medical Center

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85610
  • Insurance Median: $67
  • Cash Discount Price: $160
  • vs. Medicare Baseline: 15.62x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at Eastern Idaho Regional Medical Center is $67. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $160. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 15.62x the Medicare baseline. Located in 3100 Channing Way, Idaho Falls, ID.
Cash / Self-Pay
$160

Average discount available for prompt cash payment at this facility.

Insurance Median
$67

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: $160 (3730%)
Insurance Median: $67 (1562%)
Cash: $160 (3730% of Medicare)
Ins. Median: $67 (1562% 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 1562% of the Medicare baseline (a markup of 1462%). 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
Blue Cross Blue Shield $4 - $152 93%
Humana $4 - $134 93%
Molina $4 93%
Prime Health $4 - $136 93%
Regence Blue Shield $4 93%
Rexburg Care And Rehab $4 93%
Triwest Healthcare Alliance $4 93%
United $4 - $93 93%
Veteran'S Administration $4 93%
Regence $7 163%
Select Health $48 1119%
Select Health Ichn Brightpath $48 - $54 1119%
Select Health Idaho (Eirmc Only) $51 1189%
Aetna $63 - $78 1469%
Doug Andrus Distributing $64 1492%
Pacificsource Health $67 - $86 1562%
University Of Utah $67 1562%
Mountain Health Co-Op $80 - $120 1865%
Cigna $88 2051%
First Choice Health Of Washington $96 2238%
Moda $100 2331%
Dmba $103 2401%
Geha Ppo Usa $128 2984%
Multiplan $134 - $144 3124%
First Choice Of The Midwest $144 3357%
Interwest Health $144 3357%
St. John'S Health Network $144 3357%
Coventry First Health $146 3403%
Shashone-Bannock Tribal Health $160 3730%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3100 Channing Way, Idaho Falls, ID 83404
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals