CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: Fisher-Titus Hospital

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85610
Insurance Median: $11
Cash Discount Price: $20
vs. Medicare Baseline: 2.56x Medicare

The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at Fisher-Titus Hospital is $11. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $20. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 2.56x the Medicare baseline. Located in 272 Benedict Avenue, Norwalk, OH.

Cash / Self-Pay

$20

Average discount available for prompt cash payment at this facility.

Insurance Median

$11

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: $20 (466%)

Insurance Median: $11 (256%)

Cash: $20 (466% of Medicare)

Ins. Median: $11 (256% 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 256% of the Medicare baseline (a markup of 156%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

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

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Coresource	$3	70%
First Health	$3 - $29	70%
Humana	$3 - $4	70%
Aetna	$4 - $28	93%
Blue Cross Blue Shield	$4 - $29	93%
Buckeye	$4 - $6	93%
Caresource	$4 - $6	93%
Cigna	$4 - $26	93%
Frontpath	$4	93%
Martin'S Point	$4	93%
Medical Mutual Of Ohio	$4 - $19	93%
Paramount	$4 - $29	93%
Perennial Advantage	$4	93%
Sidecar	$4 - $22	93%
Summacare	$4 - $28	93%
UnitedHealthcare	$4 - $29	93%
Valor Health	$4	93%
Wellcare	$4	93%
Zing Health	$4	93%
Amerihealth	$6	140%
Molina	$6	140%
Health Ohio Network	$8 - $22	186%
Tricare	$9 - $26	210%
Claimsdoc	$10 - $26	233%
Healthscope	$11 - $29	256%
Multiplan	$11 - $29	256%
Ohio Health Choice	$11 - $29	256%
Emerald Health	$12 - $31	280%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $20.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 85610.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Fisher-Titus Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 85610.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.