CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: Ascension River District Hospital

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85610
  • Insurance Median: $5
  • Cash Discount Price: $13
  • vs. Medicare Baseline: 1.17x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at Ascension River District Hospital is $5. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $13. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 1.17x the Medicare baseline. Located in 4100 River Rd, East China, MI.
Cash / Self-Pay
$13

Average discount available for prompt cash payment at this facility.

Insurance Median
$5

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: $13 (303%)
Insurance Median: $5 (117%)
Cash: $13 (303% of Medicare)
Ins. Median: $5 (117% 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%
Amerihealth Vip Care $4 93%
Great Lakes Health Plan $4 93%
Harbor Advantage Hmo $4 93%
Humana $4 93%
Medicare (plans) $4 93%
Meridian Wellcare $4 93%
Molina Advantage $4 93%
Molina Health Link $4 93%
Total Health Care $4 93%
Tricare $4 93%
Veterans Choice $4 93%
Ambetter / Centene $5 117%
Molina Market Place $5 117%
Phcs Pos $5 117%
Phcs Ppo $5 117%
Ahlic $6 140%
Hap Hmo $6 140%
Hap Preferred $6 140%
Priority Hmo $6 140%
Smarthealth $6 140%
Aaa-Auto Insurance $8 186%
Ppom $12 280%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 4100 River Rd, East China, MI 48054
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals