CMS Price Transparency Data
Blood test, clotting time (PT/INR)
Facility: Avoyelles Hospital
Billing Code: 85610 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 85610
- Insurance Median: $70
- Cash Discount Price: $35
- vs. Medicare Baseline: 16.32x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at Avoyelles Hospital is $70. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $35. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 16.32x the Medicare baseline. Located in 4231 Highway 1192, Marksville, LA.
Cash / Self-Pay
$35
Average discount available for prompt cash payment at this facility.
Insurance Median
$70
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: $35 (816%)
Insurance Median: $70 (1632%)
Cash: $35 (816% of Medicare)
Ins. Median: $70 (1632% 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 1632% of the Medicare baseline (a markup of 1532%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
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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 | $4 - $65 | 93% |
| Bankers Life | $4 | 93% |
| Champva | $4 | 93% |
| Cigna | $4 - $66 | 93% |
| Correct Cr Int Hlt | $4 - $24 | 93% |
| Humana | $4 - $66 | 93% |
| Mcd Amerihealth Caritas | $4 - $24 | 93% |
| Mcd Healthy Blue | $4 - $24 | 93% |
| Mcd La Hc Conn | $4 - $24 | 93% |
| Mcr Lagniappe | $4 | 93% |
| Medeico Ins Co | $4 | 93% |
| Medicaid / KanCare | $4 - $24 | 93% |
| Medicare (plans) | $4 | 93% |
| Mmc Allwell | $4 | 93% |
| Mmc Blue Advantage | $4 | 93% |
| Mmc Healthy Blue Dual Adv | $4 | 93% |
| Mmc Mcr Hmo Miscellaneous | $4 | 93% |
| Mmc Priority Hlth Pffs | $4 | 93% |
| Mmc Vantage Hlth | $4 | 93% |
| Mmc Wellcare | $4 | 93% |
| Mutual Of Omaha | $4 | 93% |
| Neba Inc | $4 | 93% |
| Philadelphia American Lif | $4 | 93% |
| Sentinel Security Life | $4 | 93% |
| Trustmark Health Benefits | $4 - $116 | 93% |
| Tunica Biloxi | $4 - $116 | 93% |
| United Amer Ins | $4 | 93% |
| UnitedHealthcare | $4 - $24 | 93% |
| Veterans Evaluation Serv | $4 | 93% |
| Wps Vacca | $4 | 93% |
| All Savers | $5 | 117% |
| Geha | $5 | 117% |
| Mcd Ms | $5 - $27 | 117% |
| United Hlth One | $5 | 117% |
| Gulf South Zelis | $6 | 140% |
| Amer Contl Ins | $7 - $65 | 163% |
| Blue Cross Blue Shield | $7 | 163% |
| Coventry | $7 - $65 | 163% |
| First Choice Health | $7 - $65 | 163% |
| Meritan Health | $7 - $116 | 163% |
| Ofc Of Grp Bene | $7 | 163% |
| Student Assurances | $35 - $116 | 816% |
| Ppo Plus Llc | $70 | 1632% |
| Zelis Healthcare Bpa | $70 | 1632% |
| Gilsbar | $73 | 1702% |
| Amerind | $105 | 2448% |
| Applied Underwriters | $105 | 2448% |
| Sedgwick | $105 | 2448% |
| Us Dept Of Labor | $105 | 2448% |
| Wc Clms Admin Svcs | $105 | 2448% |
| Wc Clms Mgmnt Walmart | $105 | 2448% |
| Wc Esis | $105 | 2448% |
| Wc Fara | $105 | 2448% |
| Wc Gallagher Bassett | $105 | 2448% |
| Wc Guide One | $105 | 2448% |
| Wc Hartford Med | $105 | 2448% |
| Wc Luba | $105 | 2448% |
| Wc Lwcc | $105 | 2448% |
| Wc Paragon Casino Resort | $105 | 2448% |
| Wc Risk Mgmnt | $105 | 2448% |
| Wc Stone Trust | $105 | 2448% |
| Wc Summit Consulting Hold | $105 | 2448% |
| Wc Travelers Ins | $105 | 2448% |
| Wc Trs Workers Comp Claim | $105 | 2448% |
| Wc Us Dol | $105 | 2448% |
| Wc Zurich | $105 | 2448% |
| Aarp | $116 | 2704% |
| Admin Concepts | $116 | 2704% |
| All Saints Hospice | $116 | 2704% |
| All State | $116 | 2704% |
| Allegiance Health Hospice | $116 | 2704% |
| Allied Natl | $116 | 2704% |
| Amfirst | $116 | 2704% |
| Avoy Parish School Board | $116 | 2704% |
| Avoyelles Parish Sheriff | $116 | 2704% |
| Bollinger | $116 | 2704% |
| Ccmsi | $116 | 2704% |
| Central States | $116 | 2704% |
| Christus Health Plan | $116 | 2704% |
| Compassionate Care Hospic | $116 | 2704% |
| Core Source | $116 | 2704% |
| Coushatta Hlth Dept | $116 | 2704% |
| Ebms | $116 | 2704% |
| Federated Ins | $116 | 2704% |
| Feedom Life | $116 | 2704% |
| Fidelity Standard Life Co | $116 | 2704% |
| Fox Everette | $116 | 2704% |
| Guarantee Trust | $116 | 2704% |
| Heart Of Hospice | $116 | 2704% |
| Hos Christus Hospice | $116 | 2704% |
| Hos Guardian Hospice Care | $116 | 2704% |
| Hos Harbor Hospice Alex | $116 | 2704% |
| Hos La Hospice Palliative | $116 | 2704% |
| Hos Passages Hospice N. | $116 | 2704% |
| Hos St Joseph Hospice | $116 | 2704% |
| Hospice Miscellaneous | $116 | 2704% |
| Ins Mgmnt Admin | $116 | 2704% |
| Ins Tpa | $116 | 2704% |
| Liberty Health Share | $116 | 2704% |
| Lumico | $116 | 2704% |
| Manhattan Life Ins | $116 | 2704% |
| Medi Share | $116 | 2704% |
| Misc Comm | $116 | 2704% |
| Nalc | $116 | 2704% |
| New Era Life | $116 | 2704% |
| North American | $116 | 2704% |
| Phcs | $116 | 2704% |
| Physicians Mutual | $116 | 2704% |
| Pipeline Ind Bene | $116 | 2704% |
| Progressive Auto | $116 | 2704% |
| Reliance Standard Life | $116 | 2704% |
| Rural Carriers | $116 | 2704% |
| Shelter Ins Co | $116 | 2704% |
| Sierre Health And Life | $116 | 2704% |
| State Farm | $116 | 2704% |
| State Mutual | $116 | 2704% |
| Sterling Investors | $116 | 2704% |
| The Health Plan | $116 | 2704% |
| Tribal Hlth Partners | $116 | 2704% |
| Tricare | $116 | 2704% |
| Uct | $116 | 2704% |
| Unified Life | $116 | 2704% |
| Usaa Life Ins | $116 | 2704% |
| Web-Tpa | $116 | 2704% |
| Woodmen Of The World | $116 | 2704% |