CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: Ohio Valley Surgical Hospital

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85610
  • Insurance Median: $11,885
  • Cash Discount Price: $40
  • vs. Medicare Baseline: 2770.40x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at Ohio Valley Surgical Hospital is $11,885. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $40. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 2770.40x the Medicare baseline. Located in 100 West Main Street, Springfield, OH.
Cash / Self-Pay
$40

Average discount available for prompt cash payment at this facility.

Insurance Median
$11,885

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: $40 (932%)
Insurance Median: $11,885 (277040%)
Cash: $40 (932% of Medicare)
Ins. Median: $11,885 (277040% 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 277040% of the Medicare baseline (a markup of 276940%). 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
Blue Cross Blue Shield $2 - $40,293 47%
UnitedHealthcare $5 - $17,571 117%
Aetna $6 - $20,896 140%
Geha $6 - $20,896 140%
Genworth $6 - $20,896 140%
Mail Handlers $6 - $20,896 140%
Meritain $6 - $20,896 140%
Meritain Heatlh $6 - $20,896 140%
Mhbp $6 - $20,896 140%
Ngs Coresource $6 - $20,896 140%
Nippon Life $6 - $20,896 140%
Pacific Source $6 - $20,896 140%
Personify Health $6 - $20,896 140%
Mmo Cin. Hmo $30 - $42 699%
Mmoh $30 - $11,885 699%
Mmoh (Supermed) $30 - $31 699%
Medicare (plans) $40 - $12,264 932%
Luminare Health $59 1375%
Medben $59 1375%
Ohio Health $59 1375%
Preferred Health $59 1375%
Medicaid / KanCare $3,557 - $17,827 82914%
Amerihealth Caritas Of Ohio $3,657 85245%
Buckeye Community Health Plan $4,022 93753%
Molina Mcd $4,084 95198%
Caresource $4,364 - $17,827 101725%
Humana $4,493 - $11,919 104732%
Aarp $11,885 277040%
Aarp Supplemental $11,885 277040%
American Continental Insurance $11,885 277040%
American Continental Life $11,885 277040%
American Republic $11,885 277040%
American Retirement $11,885 277040%
Aultcare Primetime Health Plan $11,885 277040%
Bankers Fidelity $11,885 277040%
Bankers Life And Casualty $11,885 277040%
Central States $11,885 277040%
Champus $11,885 277040%
Cigna $11,885 - $18,817 277040%
Communicare Advantage $11,885 277040%
Everest $11,885 277040%
Gateway Health Plan $11,885 277040%
Medigold $11,885 277040%
Molina $11,885 277040%
Molina Dual Mcr $11,885 277040%
Molina Marketplace $11,885 277040%
Molina Dual Mcr $11,885 277040%
Molina Mcr $11,885 277040%
Molina Mcr Mcd $11,885 277040%
Molina Mcr+Mcd $11,885 277040%
Patient No Pay $11,885 277040%
Prosperity Supplement $11,885 277040%
Self Pay Imaging $11,885 277040%
Wellcare By Allwell $11,885 277040%
Wraparound Pl Supp $11,885 277040%
The Health Plan $12,479 290886%
Devoted Health $13,707 319510%
Employer Direct $15,703 366037%
Golden Rule $17,571 409580%
Medica $17,571 409580%
Oxford $17,571 409580%
Shl $17,571 409580%
Surest $17,571 409580%
Ushealth $17,571 409580%
Caresourse $17,827 415548%
Healthgram $18,817 438625%
Nalc $18,817 438625%
Samba $18,817 438625%
Sbma $18,817 438625%
Unified Group $18,817 438625%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 100 West Main Street, Springfield, OH 45502
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals