CMS Price Transparency Data
Blood test, clotting time (PT/INR)
Facility: Chelsea Hospital
Billing Code: 85610 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 85610
- Insurance Median: $11
- Cash Discount Price: $25
- vs. Medicare Baseline: 2.56x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at Chelsea Hospital is $11. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $25. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 2.56x the Medicare baseline. Located in 775 S Main St, Chelsea, MI.
Cash / Self-Pay
$25
Average discount available for prompt cash payment at this facility.
Insurance Median
$11
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: $25 (583%)
Insurance Median: $11 (256%)
Cash: $25 (583% of Medicare)
Ins. Median: $11 (256% 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 256% of the Medicare baseline (a markup of 156%). 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.
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Blue Cross Blue Shield | $2 - $5 | 47% |
| Medicaid / KanCare | $2 | 47% |
| Aetna | $4 - $20 | 93% |
| Align Senior Care | $4 | 93% |
| Angela Hospice | $4 | 93% |
| Arbor Hospice | $4 | 93% |
| Blue Care Network Advantage | $4 | 93% |
| Heartland Hospice | $4 | 93% |
| Medicare (plans) | $4 | 93% |
| UnitedHealthcare | $4 - $29 | 93% |
| Wc Accident Fund | $4 - $11 | 93% |
| Wc Advantage | $4 - $11 | 93% |
| Wc Aig | $4 - $11 | 93% |
| Wc Allied | $4 - $11 | 93% |
| Wc Amerisure | $4 - $11 | 93% |
| Wc Amtrust | $4 - $11 | 93% |
| Wc Asu Risk Mgt | $4 - $11 | 93% |
| Wc Berkley Admin | $4 - $11 | 93% |
| Wc Broadspire | $4 - $11 | 93% |
| Wc Bunch & Associates | $4 - $11 | 93% |
| Wc Ccmsi | $4 - $11 | 93% |
| Wc Emc Insurance Company | $4 - $11 | 93% |
| Wc Esis | $4 - $11 | 93% |
| Wc Fcci | $4 - $11 | 93% |
| Wc Federated | $4 - $11 | 93% |
| Wc Gallagher Bassett | $4 - $11 | 93% |
| Wc Genex Care For Ohio | $4 - $11 | 93% |
| Wc Guard Insurance Company | $4 - $11 | 93% |
| Wc Hartford | $4 - $11 | 93% |
| Wc Liberty Mutual | $4 - $11 | 93% |
| Wc Meijers | $4 - $11 | 93% |
| Wc Michigan | $4 - $11 | 93% |
| Wc Mitchell Frankenmuth | $4 - $11 | 93% |
| Wc Pma | $4 - $11 | 93% |
| Wc Sedgwick | $4 - $11 | 93% |
| Wc Sentry | $4 - $11 | 93% |
| Wc Travelers | $4 - $11 | 93% |
| Wc Tristar | $4 - $11 | 93% |
| Wc Walmart | $4 - $11 | 93% |
| Wc Zurich | $4 - $11 | 93% |
| Bcn Domestic | $5 | 117% |
| Blue Benefit Administrators Of Massachusetts | $5 | 117% |
| Blue Care Network | $5 | 117% |
| Blue Distinction Transplant | $5 | 117% |
| Blue Shield - Ca | $5 | 117% |
| Blue Shield - Id (Regence) | $5 | 117% |
| Blue Shield - Ny Highmark Northeastern | $5 | 117% |
| Blue Shield - Ny Highmark Western | $5 | 117% |
| Blue Shield - Pa (Highmark) | $5 | 117% |
| Blue Shield - Wa (Regence) | $5 | 117% |
| Cca - Zing Health | $5 | 117% |
| Health Choices | $5 - $29 | 117% |
| Kaiser Domestic | $5 | 117% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $5 | 117% |
| Geha | $6 - $29 | 140% |
| Meritain | $6 | 140% |
| Molina Marketplace | $6 | 140% |
| Health Cost Solutions | $7 | 163% |
| U Of M Health Plan | $7 | 163% |
| Vitalcore | $7 | 163% |
| Wellpath | $7 | 163% |
| Access Health | $9 - $29 | 210% |
| Acclaim | $9 - $29 | 210% |
| Administrative Concepts | $9 - $29 | 210% |
| Allegeant | $9 - $29 | 210% |
| Ameriben | $9 - $29 | 210% |
| American Family | $9 - $29 | 210% |
| American Healthcare Alliance | $9 - $29 | 210% |
| American National | $9 - $29 | 210% |
| American Republic | $9 - $29 | 210% |
| Amerihealth | $9 - $29 | 210% |
| Aultcare | $9 - $29 | 210% |
| Automated Benefit Services | $9 - $29 | 210% |
| Auxiant | $9 - $29 | 210% |
| Benefit Administrative Systems,Llc | $9 - $29 | 210% |
| Boon Chapman | $9 - $29 | 210% |
| Cam Administrative Services | $9 - $29 | 210% |
| Christian Brother Services | $9 - $29 | 210% |
| Christian Brothers Holy Cross | $9 - $29 | 210% |
| Comprehensive Benefits | $9 - $29 | 210% |
| Continental Life Insurance | $9 - $29 | 210% |
| Coventry | $9 - $29 | 210% |
| Custom Benefit Administrators | $9 - $29 | 210% |
| Employee Benefit Concepts | $9 - $29 | 210% |
| Employee Benefit Management | $9 - $29 | 210% |
| Enterprise Group Planning | $9 - $29 | 210% |
| First Health | $9 - $29 | 210% |
| Freedom Life Insurance Company | $9 - $29 | 210% |
| Group Administrators | $9 - $29 | 210% |
| Group Marketing Services | $9 - $29 | 210% |
| Guardian | $9 - $29 | 210% |
| Health America | $9 - $29 | 210% |
| Healthcare Management Admin | $9 - $29 | 210% |
| Healthez | $9 - $29 | 210% |
| Hospice Of Michigan | $9 - $30 | 210% |
| Humana | $9 - $29 | 210% |
| Insight | $9 - $29 | 210% |
| Intercare | $9 - $29 | 210% |
| Jfp Benefit Management | $9 - $29 | 210% |
| Jp Farley Corporation | $9 - $29 | 210% |
| Key Benefit Administrator | $9 - $29 | 210% |
| Liberty Union Life Assurance Co | $9 - $29 | 210% |
| Lucent Health | $9 - $29 | 210% |
| Luminare Health | $9 - $29 | 210% |
| Luminare Health (Detroit) | $9 - $29 | 210% |
| Magnacare | $9 - $29 | 210% |
| Medben | $9 - $29 | 210% |
| Medcost | $9 - $29 | 210% |
| Medical Mutual | $9 - $29 | 210% |
| Mutual Health Services | $9 - $29 | 210% |
| Mutual Of Omaha | $9 - $29 | 210% |
| Ncas | $9 - $29 | 210% |
| Nippon Life Ins | $9 - $29 | 210% |
| Nova | $9 - $29 | 210% |
| Painters Union Insurance Fund | $9 - $29 | 210% |
| Physicians Mutual | $9 - $29 | 210% |
| Plumbers Local 98 Insurance Fund | $9 - $29 | 210% |
| Prairie States | $9 - $29 | 210% |
| Preferred One | $9 - $29 | 210% |
| Primary Physician Care | $9 - $29 | 210% |
| Professional Benefit Administrators | $9 - $29 | 210% |
| Siho Insurance Services | $9 - $29 | 210% |
| Sisco Benefits | $9 - $29 | 210% |
| The Loomis Company | $9 - $29 | 210% |
| Unicare | $9 - $29 | 210% |
| Us Health And Life | $9 - $29 | 210% |
| Valenz | $9 - $29 | 210% |
| Western & Southern Financial Group | $9 - $29 | 210% |
| Wps | $9 - $29 | 210% |
| 1199 National Benefit Fund | $10 - $32 | 233% |
| Allied National Global Care | $10 - $32 | 233% |
| Asrm - Reliance Standard Life Insurance | $10 - $32 | 233% |
| Christian Care Ministry | $10 - $32 | 233% |
| Cigna | $10 - $30 | 233% |
| Dean Health | $10 - $32 | 233% |
| Employee Benefit Logistic | $10 | 233% |
| Fallon Health | $10 - $32 | 233% |
| Family Life Insurance Company | $10 - $32 | 233% |
| Ghc Scw | $10 - $32 | 233% |
| Group Pension Administrators | $10 - $32 | 233% |
| Hap | $10 - $33 | 233% |
| Health Partners | $10 - $33 | 233% |
| International Benefit Administrators | $10 - $32 | 233% |
| Lifetime Benefit Solutions | $10 - $32 | 233% |
| Manhattan Life | $10 - $32 | 233% |
| Medi Share | $10 - $32 | 233% |
| Multiplan | $10 - $32 | 233% |
| Mvp | $10 - $32 | 233% |
| Pai | $10 - $32 | 233% |
| Pan-American Life | $10 - $32 | 233% |
| Paramount Hmo | $10 - $32 | 233% |
| Phcs | $10 - $32 | 233% |
| Priority Health | $10 - $11 | 233% |
| Trinity Health Share | $10 - $32 | 233% |
| Tufts Health Plan | $10 - $33 | 233% |
| Prime Health Services | $11 - $34 | 256% |
| Three Rivers Provider Network | $12 - $39 | 280% |
| Asr Health Benefits | $14 | 326% |
| Caresource | $14 | 326% |
| Cmh Detroit Wayne Integrated Health Network | $14 - $43 | 326% |
| Cmh Jackson County/Lifeways | $14 - $43 | 326% |
| Cmh Lenawee County | $14 - $43 | 326% |
| Cmh Livingston County | $14 - $43 | 326% |
| Cmh Misc | $14 - $43 | 326% |
| Cmh Monroe County | $14 - $43 | 326% |
| Cmh Washtenaw County | $14 - $43 | 326% |
| Magellan Behavioral Health | $14 - $43 | 326% |
| Varipro | $14 | 326% |