CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: Holland Community Hospital

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85610
  • Insurance Median: $6
  • Cash Discount Price: $14
  • vs. Medicare Baseline: 1.40x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at Holland Community Hospital is $6. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $14. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 1.40x the Medicare baseline. Located in 602 Michigan Ave, Holland, MI.
Cash / Self-Pay
$14

Average discount available for prompt cash payment at this facility.

Insurance Median
$6

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: $14 (326%)
Insurance Median: $6 (140%)
Cash: $14 (326% 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.

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
Molina Mcaid - All Plans $1 - $11 23%
Ph Mcaid $1 - $11 23%
Nomi Health - All Plans $2 - $84 47%
UnitedHealthcare $2 - $50 47%
Benefit Source Inc-All Plans $3 - $32 70%
First Health-All Plans $3 - $32 70%
Integrated Health Plans-All Plans $3 - $33 70%
Multiplan - All Plans $3 - $30 70%
Usa Managed Care-All Plans $3 - $32 70%
Aetna $4 - $6 93%
Blue Care Network - All Plans $4 93%
Blue Cross Blue Shield $4 - $5 93%
Health Alliance Mcr Adv $4 93%
Life Circles-All Plans $4 93%
Meridian Mcaid Profee Only-All Plans $4 93%
Ph Mcr Adv $4 93%
Priority Health - All Other Plans $4 - $13 93%
Va Ccn - All Plans $4 93%
Cigna $5 - $12 117%
Cofinity -All Plans $5 117%
Longevity Health Plan-All Plans $5 117%
Asr - All Plans $6 - $7 140%
Health Alliance Ahl - All Other Plans $6 - $7 140%
Health Alliance Hmo $6 - $7 140%
Sisco Epi $7 163%
Sisco-All Other Plans $7 163%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 602 Michigan Ave, Holland, MI 49423
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals