CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: Strong Memorial Hospital

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85610
  • Insurance Median: $4
  • Cash Discount Price: $26
  • vs. Medicare Baseline: 0.93x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at Strong Memorial Hospital is $4. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $26. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 0.93x the Medicare baseline. Located in 601 Elmwood Ave, Rochester, NY.
Cash / Self-Pay
$26

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: $26 (606%)
Insurance Median: $4 (93%)
Cash: $26 (606% 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
Cigna $3 - $4 70%
Highmark Bc/Bs Of Western Ny [5143] $3 70%
Medicaid / KanCare $3 - $6 70%
Medicare (plans) $3 - $6 70%
Mvp [2900] $3 - $4 70%
Aetna $4 - $7 93%
Blue Cross Blue Shield $4 - $5 93%
Capital District Physicians Health Plan (Cdphp) [51490] $4 93%
Capital District Physicians Health Plan (Cdphp) [5149] $4 93%
Elderplan [1316] $4 93%
Excellus Bc/Bs [2201] $4 - $8 93%
Excellus Bc/Bs [2201], Bc/Bs Out Of Area [2401] $4 - $14 93%
Excellus [2201] $4 93%
Fidelis [5155] $4 - $9 93%
Icircle [1728] $4 93%
Independent Health [5156] $4 - $6 93%
Martins Point [1205] $4 93%
Nascentia [1729] $4 93%
UnitedHealthcare $4 - $7 93%
Humana $5 117%
Molina Healthcare [1723], Molina Healthcare [5189] $5 117%
Molina Healthcare [5189] $9 210%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 601 Elmwood Ave, Rochester, NY 14642
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals