CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: Garrett Regional Medical Center

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85610
  • Insurance Median: $10
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 2.33x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at Garrett Regional Medical Center is $10. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 2.33x the Medicare baseline. Located in 251 North Fourth Street, Oakland, MD.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$10

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%)
Insurance Median: $10 (233%)
Ins. Median: $10 (233% 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 233% of the Medicare baseline (a markup of 133%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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 - $18 93%
Amerigroup $4 - $17 93%
Carefirst Community Health Plan $4 - $17 93%
Carefirst D-Snp $4 - $17 93%
Carefirst Ppo $4 - $17 93%
Caresource Wv $4 - $16 93%
Coventry $4 - $17 93%
Highmark Health Options Wv $4 - $17 93%
Humana $4 - $17 93%
Maryland Physicians Care $4 - $17 93%
Medicare (plans) $4 - $17 93%
Multiplan $4 - $17 93%
Provider Partners $4 - $17 93%
Senior Advantage $4 - $17 93%
The Health Plan Of Wv $4 - $17 93%
United Mine Workers Of America $4 - $18 93%
UnitedHealthcare $4 - $18 93%
Wellpoint Wv $4 - $17 93%
Alliance Coal $5 - $18 117%
American Correctional Healthcare $5 - $18 117%
Carefirst Commercial $5 - $18 117%
Cigna $5 - $18 117%
First Health $5 - $18 117%
John Hopkins Healthcare $5 - $18 117%
Peak Commercial $5 - $18 117%
Stratose/ 4 Most $5 - $18 117%
The Health Plan $5 - $18 117%
The Health Plan Commercial $5 - $18 117%
Upmc Commercial $5 - $18 117%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 251 North Fourth Street, Oakland, MD 21550
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals