CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: Vidant Chowan Hospital

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85610
Insurance Median: $55
Cash Discount Price: $50
vs. Medicare Baseline: 12.82x Medicare

The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at Vidant Chowan Hospital is $55. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $50. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 12.82x the Medicare baseline. Located in 211 Virginia Rd, Edenton, NC.

Cash / Self-Pay

$50

Average discount available for prompt cash payment at this facility.

Insurance Median

$55

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: $50 (1166%)

Insurance Median: $55 (1282%)

Cash: $50 (1166% of Medicare)

Ins. Median: $55 (1282% 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 1282% of the Medicare baseline (a markup of 1182%). 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
Aetna	$4 - $79	93%
Trillium [1296]	$5	117%
Carolina Complete Health [1317]	$7	163%
Wellcare [1320]	$7	163%
Amerihealth McAid Adv [1316]	$7	163%
Blue Cross Blue Shield	$7 - $58	163%
Humana	$25 - $30	583%
Liberty Advantage [1313]	$28 - $33	653%
UnitedHealthcare	$28 - $59	653%
Longevity Health [1411]	$35 - $41	816%
Nc Dept of Public Safety [1095]	$46 - $54	1072%
Medcost [1067]	$52 - $64	1212%
Cigna	$70 - $91	1632%
Multiplan [1031]	$78 - $91	1818%

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 $50.
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 Vidant Chowan Hospital 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.