CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: Hillcrest Hospital Cushing

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85610
Insurance Median: $236
Cash Discount Price: $101
vs. Medicare Baseline: 55.01x Medicare

The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at Hillcrest Hospital Cushing is $236. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $101. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 55.01x the Medicare baseline. Located in 1027 East Cherry Street, Cushing, OK.

Cash / Self-Pay

$101

Average discount available for prompt cash payment at this facility.

Insurance Median

$236

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: $101 (2354%)

Insurance Median: $236 (5501%)

Cash: $101 (2354% of Medicare)

Ins. Median: $236 (5501% 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 5501% of the Medicare baseline (a markup of 5401%). 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
Black Lung [6055]	$84	1958%
Healthcare Highways [2210]	$84 - $101	1958%
Hooray Health [8000]	$84	1958%
Lucent Health [6000]	$84	1958%
Oncology Patient Assistance Programs [2295]	$84	1958%
Oscar Insurance Company [7005]	$84	1958%
Healthscope Benefits [2290]	$92	2145%
UnitedHealthcare	$92 - $167	2145%
Web Tpa [2115]	$101	2354%
Cigna	$165	3846%
Healthpartners [1500]	$165	3846%
National Association Of Letter Carriers [1695]	$165	3846%
Pba [1775]	$165	3846%
Global Health [1430]	$209	4872%
First Health [1375]	$234 - $297	5455%
Multiplan [1680]	$234 - $297	5455%
Healthcare Solutions [1485]	$239	5571%
Community Care [1290]	$280	6527%
Fmh Benefit Services [1390]	$280	6527%
Group Resources [1455]	$280	6527%
Phcs [1780]	$280 - $297	6527%
Healthsmart [1505]	$286	6667%
Administrative Concepts [1005]	$297	6923%
Allied Benefit Systems Inc [1030]	$297	6923%
Allied National Global Care [1035]	$297	6923%
Gilsbar [1425]	$297	6923%
Healthnet [1495]	$297	6923%
Mutual Of Omaha [1685]	$297	6923%
New Era Life Insurance Company [1705]	$297	6923%
Pan American Life Insurance Co [1770]	$297	6923%
Trustmark [2030]	$297	6923%
Universal Fidelity [2085]	$297	6923%
Pending Ssi [1616]	$337	7855%

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 $101.
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 Hillcrest Hospital Cushing 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.