CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: Carolinas Rehabilitation

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85610
Insurance Median: $66
Cash Discount Price: $68
vs. Medicare Baseline: 15.38x Medicare

The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at Carolinas Rehabilitation is $66. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $68. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 15.38x the Medicare baseline. Located in 1100 Blythe Blvd, Charlotte, NC.

Cash / Self-Pay

$68

Average discount available for prompt cash payment at this facility.

Insurance Median

$66

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: $68 (1585%)

Insurance Median: $66 (1538%)

Cash: $68 (1585% of Medicare)

Ins. Median: $66 (1538% 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 1538% of the Medicare baseline (a markup of 1438%). 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 - $115	93%
Cigna	$4 - $91	93%
Humana	$4	93%
Amerihealth Caritas	$5 - $53	117%
Blue Cross Blue Shield	$5 - $65	117%
Carolina Complete Health	$5 - $54	117%
Choicecare	$5 - $106	117%
Healthy Blue	$5 - $54	117%
UnitedHealthcare	$5 - $89	117%
Wellcare	$5 - $54	117%
Ambetter / Centene	$7 - $50	163%
Employers Health Network	$60 - $72	1399%
Physician Reach Out	$68	1585%
Medcost	$79 - $91	1841%
Quik Trip	$88	2051%
Healthgram	$108	2517%
Private Health Care Systems	$111	2587%
First Health	$115	2681%
Beechstreet	$125	2914%
Multiplan	$125	2914%

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 $68.
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 Carolinas Rehabilitation 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.