CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: Surgical Specialty Center of Baton Rouge

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85610
Insurance Median: $6
Cash Discount Price: $35
vs. Medicare Baseline: 1.40x Medicare

The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at Surgical Specialty Center of Baton Rouge is $6. 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 1.40x the Medicare baseline. Located in 8080 Bluebonnet Blvd, Baton Rouge, LA.

Cash / Self-Pay

$35

Average discount available for prompt cash payment at this facility.

Insurance Median

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: $6 (140%)

Cash: $35 (816% of Medicare)

Ins. Median: $6 (140% 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.

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
Uhc_Commcoffee	$2	47%
Aetna	$4	93%
Amerihealth	$4	93%
Blue Cross Blue Shield	$4 - $5	93%
Cigna	$4	93%
Healthy_Blue	$4	93%
Humana	$4 - $6	93%
Lhc	$4	93%
Medadv-Peoples	$4	93%
Medicaid / KanCare	$4	93%
Medicare (plans)	$4	93%
United	$4	93%
UnitedHealthcare	$4	93%
United_Caid	$4	93%
Va	$4	93%
Wellcare	$4	93%
Verity	$5	117%
Lucent	$6	140%
Ambetter / Centene	$8	186%
Workcomp_Saints	$10	233%
Lsufirst	$11	256%
Gilsbar	$23	536%
Multiplan-Pos	$28	653%
Multiplan-Ppo	$28	653%
Ppoplus	$29	676%
Stjude	$31	723%
Bayou-Med	$33	769%
Dma	$33	769%
Lsu	$33	769%
Southern-Univ	$33	769%
Womans_Hosp	$33	769%
Reny	$35	816%
Ehn	$38	886%
Workcomp_3R	$38	886%
Three_Rivers	$40	932%
Workcomp_Strat	$40	932%
Geha	$41	956%
Workcomp_Fp	$42	979%
Usa_Mco	$44	1026%

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 $35.
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 Surgical Specialty Center of Baton Rouge 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.