CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: Highlands Cashiers Hospital

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85610
  • Insurance Median: $2
  • Cash Discount Price: $5
  • vs. Medicare Baseline: 0.47x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at Highlands Cashiers Hospital is $2. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 0.47x the Medicare baseline. Located in 190 Hospital Drive, Highlands, NC.
Cash / Self-Pay
$5

Average discount available for prompt cash payment at this facility.

Insurance Median
$2

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: $5 (117%)
Insurance Median: $2 (47%)
Cash: $5 (117% of Medicare)
Ins. Median: $2 (47% 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
Amerihealth Caritas $2 47%
Blue Cross Blue Shield $2 47%
Caresource $2 47%
Cigna $2 47%
Medcost $2 - $3 47%
Partners Health Management $2 47%
United $2 - $3 47%
Vaya Health $2 47%
Wellcare $2 47%
Aetna $3 70%
Magellan $3 70%
Magellan Behavioral Health $3 70%
Avalon Administrative Services $4 93%
Multiplan $4 93%
Prime Health $4 93%
Amerihealth $5 117%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 190 Hospital Drive, Highlands, NC 28741
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals