CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: North Carolina Baptist Hospital

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85610
  • Insurance Median: $7
  • Cash Discount Price: $10
  • vs. Medicare Baseline: 1.63x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at North Carolina Baptist Hospital is $7. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $10. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 1.63x the Medicare baseline. Located in Medical Center Boulevard, Winston-Salem, NC.
Cash / Self-Pay
$10

Average discount available for prompt cash payment at this facility.

Insurance Median
$7

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: $10 (233%)
Insurance Median: $7 (163%)
Cash: $10 (233% of Medicare)
Ins. Median: $7 (163% 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 - $18 93%
Ambetter / Centene $4 - $5 93%
Apex $4 93%
Blue Cross Blue Shield $4 - $8 93%
Cigna $4 - $13 93%
Devoted $4 93%
Healthteam $4 93%
Humana $4 - $11 93%
Medcost $4 - $14 93%
Medicare (plans) $4 93%
UnitedHealthcare $4 - $7 93%
Wellcare $4 - $7 93%
Amerihealth $5 - $7 117%
Liberty $5 117%
Oscar $6 - $8 140%
Alliance $7 163%
Carolina Complete $7 163%
Health Blue $7 163%
Partners $7 163%
Trillium $7 163%
Vaya $7 163%
Directnet $11 - $12 256%
Cone Health $13 - $15 303%
Healthgram $13 - $15 303%
First Carolina Care $15 - $17 350%
Private Healthcare Systems $16 - $17 373%
Multiplan $17 - $19 396%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: Medical Center Boulevard, Winston-Salem, NC 27157
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals