CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: Frankfort Regional Medical Center

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85610
Insurance Median: $69
Cash Discount Price: $266
vs. Medicare Baseline: 16.08x Medicare

The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at Frankfort Regional Medical Center is $69. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $266. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 16.08x the Medicare baseline. Located in 299 Kings Daughters Drive, Frankfort, KY.

Cash / Self-Pay

$266

Average discount available for prompt cash payment at this facility.

Insurance Median

$69

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: $266 (6200%)

Insurance Median: $69 (1608%)

Cash: $266 (6200% of Medicare)

Ins. Median: $69 (1608% 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 1608% of the Medicare baseline (a markup of 1508%). 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
Blue Cross Blue Shield	$3 - $4	70%
Aetna	$4	93%
Coventry Cares	$4	93%
Devoted Health	$4	93%
Horizon Pace	$4	93%
Humana	$4 - $75	93%
Molina	$4	93%
United	$4 - $123	93%
United Behavioral Health	$4	93%
United Va	$4	93%
Wellcare	$4 - $5	93%
Corvel	$40 - $44	932%
Prime Health	$40 - $44	932%
Signature Advantage	$47 - $52	1096%
Cigna	$73 - $80	1702%
Essence Healthcare	$112 - $123	2611%
Baptist Health Network	$135 - $147	3147%
Hospice Of Central Kentucky	$157 - $172	3660%
Occupational Mc Alliance	$199 - $218	4639%
Multiplan	$237 - $259	5524%

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 $266.
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 Frankfort Regional 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.