CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: Saratoga Hospital

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85610
  • Insurance Median: $4
  • Cash Discount Price: $11
  • vs. Medicare Baseline: 0.93x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at Saratoga Hospital is $4. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $11. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 0.93x the Medicare baseline. Located in 211 Church Street, Saratoga Springs, NY.
Cash / Self-Pay
$11

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: $11 (256%)
Insurance Median: $4 (93%)
Cash: $11 (256% 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 - $179 47%
Blue Shield Highmark $3 70%
Cdphp $3 - $70 70%
Fidelis $3 - $70 70%
Mvp $3 - $4 70%
Aetna $4 - $16 93%
Blue Cross Blue Shield $4 - $92 93%
Cigna $4 93%
Emblem $4 - $5 93%
Emblem Health Ghi $4 - $5 93%
Hamaspik $4 - $73 93%
Medicaid / KanCare $4 93%
Medicare (plans) $4 93%
Nascentia Health Options $5 117%
Tricare $5 117%
Blue Shield $7 - $12 163%
Mvp Commercial $8 - $149 186%
Empire Plan Nyship $9 - $149 210%
Multiplan $9 - $169 210%
Magnacare $11 - $189 256%
Mvp Essential Plan $31 - $62 723%
Mvp Govt Programs $31 723%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 211 Church Street, Saratoga Springs, NY 12866
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals