CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: Atlanticare Regional Medical Center - City Campus

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85610
  • Insurance Median: $71
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 16.55x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at Atlanticare Regional Medical Center - City Campus is $71. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 16.55x the Medicare baseline. Located in 1925 Pacific Avenue, Atlantic City, NJ.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$71

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%)
Insurance Median: $71 (1655%)
Ins. Median: $71 (1655% 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 1655% of the Medicare baseline (a markup of 1555%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

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

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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 $1 - $81 23%
Americhoice $1 23%
Amerigroup $1 23%
UnitedHealthcare $1 - $70 23%
Wellcare $1 23%
Ambetter / Centene $2 47%
Health Partners Plan $3 - $24 70%
Devoted Health Plan $4 - $49 93%
Oxford $4 - $74 93%
Global Exchange Managed Care $6 140%
Horizon $14 - $69 326%
Self Pay $15 350%
Magnacare $39 - $88 909%
Cigna $41 - $49 956%
Evernorth $49 1142%
Great West Life $49 1142%
Qualcare Commercial $49 1142%
Amerihealth $63 - $82 1469%
Active Care Plus $64 1492%
First Mco $64 1492%
Mutual Of Omaha $64 1492%
Qualcare Wc $64 1492%
Consumer Health Network (Chn) $69 - $88 1608%
Donio Trucking $69 1608%
Devon/ Ullicare $74 1725%
Coventry Health Care $78 1818%
Private Healthcare System (Phcs) $78 1818%
Blue Cross Blue Shield $81 1888%
Health Payors Org $83 1935%
Health South $83 1935%
Metrahealth Of Nj $83 1935%
Prime Health Services $83 1935%
Three Rivers Provider Network (Trpn) $83 1935%
Active Care Nj Pip $88 2051%
Beech Street $88 2051%
Choice Care $88 2051%
Department Of Corrections $88 2051%
Galaxy Health Network $88 2051%
Health Network Inc $88 2051%
Intergroup Preferred Program $88 2051%
Mcs Commercial $88 2051%
Metracomp $88 2051%
Multiplan $88 2051%
Provider Select, Inc $88 2051%
Atlantis Health Plan $91 2121%
Master Care Inc $91 2121%
Advance Healthcare System $93 2168%
Community Care Network $93 2168%
Health Network America $93 2168%
Mcsi/Mrsi No Fault $93 2168%
Mcsi/Mrsi Worker'S Comp $93 2168%
National Health Plan $93 2168%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1925 Pacific Avenue, Atlantic City, NJ 08401
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals