CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: Glens Falls Hospital

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85610
  • Insurance Median: $4
  • Cash Discount Price: $5
  • vs. Medicare Baseline: 0.93x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at Glens Falls Hospital is $4. 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 0.93x the Medicare baseline. Located in 100 Park Street, Glens Falls, NY.
Cash / Self-Pay
$5

Average discount available for prompt cash payment at this facility.

Insurance Median
$4

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: $4 (93%)
Cash: $5 (117% of Medicare)
Ins. Median: $4 (93% 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
UnitedHealthcare $2 - $7 47%
Blue Shield $3 - $4 70%
Blue Shield Highmark $3 70%
Cdphp $3 - $83 70%
Mvp $3 - $78 70%
Aetna $4 - $9 93%
Blue Cross Blue Shield $4 - $37 93%
Cigna $4 93%
Emblem Health Ghi $4 93%
Fidelis $4 - $83 93%
Medicaid / KanCare $4 93%
Medicare (plans) $4 93%
Empire Plan Nyship $5 - $7 117%
Mvp Commercial $5 117%
Tricare $5 117%
Hamaspik $6 140%
Nascentia Health Options $6 140%
Emblem $7 - $8 163%
Magnacare $7 - $8 163%
Multiplan $8 186%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 100 Park Street, Glens Falls, NY 12801
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals