CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: Sanford Tracy Medical Center

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85610
Insurance Median: $81
Cash Discount Price: $78
vs. Medicare Baseline: 18.88x Medicare

The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at Sanford Tracy Medical Center is $81. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $78. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 18.88x the Medicare baseline. Located in 251 Fifth Street East, Tracy, MN.

Cash / Self-Pay

$78

Average discount available for prompt cash payment at this facility.

Insurance Median

$81

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: $78 (1818%)

Insurance Median: $81 (1888%)

Cash: $78 (1818% of Medicare)

Ins. Median: $81 (1888% 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 1888% of the Medicare baseline (a markup of 1788%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Blue Cross Blue Shield	$23 - $91	536%
Sanford Health Plan Align	$38	886%
Aetna	$41 - $85	956%
Health Partners	$41 - $78	956%
Medicare (plans)	$41	956%
Ucare	$41 - $86	956%
UnitedHealthcare	$41 - $82	956%
Wellmark Sd	$41	956%
Primewest	$42 - $47	979%
Security Health Plan	$53 - $54	1235%
Sanford Health Plan	$77 - $91	1795%
Medica	$85 - $93	1981%
Cigna	$87 - $88	2028%
First Choice Health Network	$87 - $88	2028%
Healthez	$87 - $88	2028%
Multiplan	$87 - $88	2028%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $78.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 85610.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Sanford Tracy Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 85610.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.