CMS Price Transparency Data
Blood test, clotting time (PT/INR)
Facility: Claiborne Memorial Medical Center
Billing Code: 85610 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 85610
- Insurance Median: $15
- Cash Discount Price: $33
- vs. Medicare Baseline: 3.50x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at Claiborne Memorial Medical Center is $15. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $33. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 3.50x the Medicare baseline. Located in 620 East College Street, Homer, LA.
Cash / Self-Pay
$33
Average discount available for prompt cash payment at this facility.
Insurance Median
$15
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: $33 (769%)
Insurance Median: $15 (350%)
Cash: $33 (769% of Medicare)
Ins. Median: $15 (350% 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 350% of the Medicare baseline (a markup of 250%). 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 - $33 | 93% |
| Amerihealth Caritas La | $4 - $22 | 93% |
| Arcadian Community Mcr Hm | $4 | 93% |
| Blue Cross Blue Shield | $4 - $21 | 93% |
| Champus | $4 | 93% |
| Champva | $4 | 93% |
| Cigna | $4 - $38 | 93% |
| Community Health Solution | $4 - $22 | 93% |
| Correctcare Intergrated | $4 - $22 | 93% |
| Healthy Blue | $4 - $22 | 93% |
| Healthy Blue Dual Adv | $4 | 93% |
| Humana | $4 - $50 | 93% |
| Kaiser Foundation Health | $4 | 93% |
| Louisiana Hc Connections | $4 - $22 | 93% |
| Magellan Services | $4 - $22 | 93% |
| Medicaid / KanCare | $4 - $22 | 93% |
| Medicare (plans) | $4 | 93% |
| Peoples Health Network | $4 | 93% |
| Pyramid Claims Mcr Hmo | $4 | 93% |
| Sterling Connect 2 | $4 | 93% |
| Sterling Premier Mc Hmo | $4 | 93% |
| Superior Health Mcr Hmo | $4 | 93% |
| Tenet Mcr Hmo | $4 | 93% |
| Tricare | $4 | 93% |
| United Hc Mcr Hmo | $4 | 93% |
| UnitedHealthcare | $4 - $22 | 93% |
| Universal Hc Mcr Hmo | $4 | 93% |
| Us Dept Of Labor | $4 | 93% |
| Vantage Health Mcr Hmo | $4 | 93% |
| Windsor Sterling Mcr Hmo | $4 | 93% |
| Wps Mvh Vapc3 | $4 | 93% |
| All Savers | $5 | 117% |
| Golden Rule Ins Co | $5 | 117% |
| United Behavioral Health | $5 | 117% |
| Ambetter / Centene | $6 | 140% |
| Commercial Insurance | $6 - $50 | 140% |
| Meritain Health | $6 - $33 | 140% |
| Vantage Health Plan Inc | $6 | 140% |
| Coventry Healthcare | $9 - $30 | 210% |
| Geha | $10 - $35 | 233% |
| Health Plus Of La | $10 - $38 | 233% |
| Apwu Healthplan | $11 - $38 | 256% |
| Great West Healthcare | $11 - $38 | 256% |
| Phcs | $12 - $40 | 280% |
| Ppo Plus | $12 - $40 | 280% |
| Sedgwick Claims Mgmt Serv | $12 - $45 | 280% |
| Workman'S Comp | $12 - $45 | 280% |
| Aarp | $15 - $50 | 350% |
| Accordia National | $15 - $50 | 350% |
| Aflac | $15 - $50 | 350% |
| Alameda Alliance Forhealt | $15 - $50 | 350% |
| American Pioneer | $15 - $50 | 350% |
| Benefit Management | $15 - $50 | 350% |
| Benesys Inc | $15 - $50 | 350% |
| Business Guarantor | $15 - $50 | 350% |
| Chubb | $15 - $50 | 350% |
| Commercial Sr. Care | $15 - $50 | 350% |
| Employee Benefit Services | $15 - $50 | 350% |
| Family Life Insurance Co | $15 - $50 | 350% |
| Farm Bureau Insurance | $15 - $50 | 350% |
| Fiserv Health Benefit | $15 - $50 | 350% |
| Gmp | $15 - $50 | 350% |
| Group And Pension Admin | $15 - $50 | 350% |
| Group Resources | $15 - $50 | 350% |
| Haik Minvielle And Grubbs | $15 - $50 | 350% |
| Harrington Benefit Svs | $15 - $50 | 350% |
| Health Design Plus | $15 - $50 | 350% |
| Health Plan | $15 - $50 | 350% |
| Healthscope Benefits | $15 - $50 | 350% |
| Insurance Management Admi | $15 - $50 | 350% |
| Jefferson National | $15 - $50 | 350% |
| John Alden Health Ins | $15 - $50 | 350% |
| John Hancock | $15 - $50 | 350% |
| Liberty Mutual | $15 - $50 | 350% |
| Mailhandlers Benefit Plan | $15 - $50 | 350% |
| Manhattan Life Ins Co | $15 - $50 | 350% |
| Mega Life And Health | $15 - $50 | 350% |
| Msa Careguard | $15 - $50 | 350% |
| Mutual Of Omaha | $15 - $50 | 350% |
| Nalc Health Benefit Plan | $15 - $50 | 350% |
| Naphcare Inc. | $15 - $50 | 350% |
| New Era Life Ins Co | $15 - $50 | 350% |
| Physicians Mutual | $15 - $50 | 350% |
| Principal Financial Group | $15 - $50 | 350% |
| Prudential Healthcare | $15 - $50 | 350% |
| Self Pay | $15 - $50 | 350% |
| State Farm | $15 - $50 | 350% |
| State Farm Insurance | $15 - $50 | 350% |
| State Mutual Insurance Co | $15 - $50 | 350% |
| Sterling Investors Life | $15 - $50 | 350% |
| Tower Life | $15 - $50 | 350% |
| Transamerica Premier Ins | $15 - $50 | 350% |
| United American | $15 - $50 | 350% |
| United Comm Travelers | $15 - $50 | 350% |
| United Teachers | $15 - $50 | 350% |
| Usable Administrator | $15 - $50 | 350% |
| Visn 16 Cfu | $15 - $50 | 350% |
| Wausau Benefits | $15 - $50 | 350% |
| Webtpa | $15 - $50 | 350% |
| Wells Fargo | $15 - $50 | 350% |
| Woodmen Of The World | $15 - $50 | 350% |