CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: Crystal Clinic Orthopaedic Center

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85610
Insurance Median: $76
Cash Discount Price: $194
vs. Medicare Baseline: 17.72x Medicare

The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at Crystal Clinic Orthopaedic Center is $76. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $194. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 17.72x the Medicare baseline. Located in 444 North Main Street, Akron, OH.

Cash / Self-Pay

$194

Average discount available for prompt cash payment at this facility.

Insurance Median

$76

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: $194 (4522%)

Insurance Median: $76 (1772%)

Cash: $194 (4522% of Medicare)

Ins. Median: $76 (1772% 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 1772% of the Medicare baseline (a markup of 1672%). 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
Bc Mcr Adv	$4	93%
Summacare Mcr Adv	$4	93%
UnitedHealthcare	$4 - $1,014	93%
The Health Plan - All Plans	$9	210%
Aultcare - All Plans	$11 - $154	256%
Health Oh Network - All Plans	$20 - $289	466%
Ohio Health Choice - All Plans	$20 - $289	466%
Med Mutual Nas	$21 - $301	490%
Multiplan - All Plans	$22 - $318	513%
Healthsmart - All Plans	$29 - $410	676%
Bc Pathway	$43 - $603	1002%
Cigna	$57 - $811	1329%
Bc Ohi/Ohii	$58 - $827	1352%
Summacare Comm - All Other Plans	$63 - $892	1469%
Med Mutual Medflex	$64 - $902	1492%
Bc Blue Access	$65 - $919	1515%
Bc Preferred	$65 - $919	1515%
Bc Trad - All Other Plans	$65 - $919	1515%
Med Mutual Aca	$72 - $1,026	1678%
Med Mutual Ppo/Pos/Hmo - All Other Plans	$80 - $1,128	1865%
Aetna	$81 - $1,143	1888%

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 $194.
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 Crystal Clinic Orthopaedic Center 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.