CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: NYU Langone Hospitals

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85610
  • Insurance Median: $9
  • Cash Discount Price: $5
  • vs. Medicare Baseline: 2.10x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at NYU Langone Hospitals is $9. 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 2.10x the Medicare baseline. Located in 550 First Avenue, New York, NY.
Cash / Self-Pay
$5

Average discount available for prompt cash payment at this facility.

Insurance Median
$9

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: $9 (210%)
Cash: $5 (117% of Medicare)
Ins. Median: $9 (210% 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 210% of the Medicare baseline (a markup of 110%). 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.

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
Centerlight $4 93%
Fidelis $4 - $7 93%
Ghi $4 - $31 93%
Healthfirst $4 93%
Healthplus $4 93%
Hip $4 - $109 93%
Medicare (plans) $4 93%
Oxford $4 93%
UnitedHealthcare $4 93%
Wellcare $4 93%
1199 $6 140%
Hamaspik $6 140%
Metroplus $6 140%
Cigna $8 186%
Blue Cross Blue Shield $10 - $13 233%
Aetna $11 - $172 256%
Magnacare $44 - $86 1026%
Multiplan $134 3124%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 550 First Avenue, New York, NY 10016
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals