CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: Holyoke Medical Center

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85610
  • Insurance Median: $4
  • Cash Discount Price: $8
  • vs. Medicare Baseline: 0.93x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at Holyoke Medical Center is $4. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $8. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 0.93x the Medicare baseline. Located in 575 Beech Street, Holyoke, MA.
Cash / Self-Pay
$8

Average discount available for prompt cash payment at this facility.

Insurance Median
$4

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: $8 (186%)
Insurance Median: $4 (93%)
Cash: $8 (186% of Medicare)
Ins. Median: $4 (93% 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.

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
Aetna $4 93%
Blue Cross Blue Shield $4 - $9 93%
Bmchp $4 93%
Commonwealth Care Alliance $4 93%
Fallon $4 - $5 93%
Health New England $4 - $5 93%
Tufts Health Plan $4 - $8 93%
Tufts Health Public Plans $4 - $5 93%
UnitedHealthcare $4 - $7 93%
Wellcare $4 93%
Wellsense Sco $4 93%
Senior Whole Health $5 117%
Wellsense Direct Metals Silver $5 117%
Cigna $6 140%
Harvard Pilgrim $7 163%
Gic Unicare $8 186%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 575 Beech Street, Holyoke, MA 01040
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals