CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: Hillcrest Hospital South

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85610
Insurance Median: $150
Cash Discount Price: $77
vs. Medicare Baseline: 34.97x Medicare

The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at Hillcrest Hospital South is $150. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $77. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 34.97x the Medicare baseline. Located in 8801 South 101St East Avenue, Tulsa, OK.

Cash / Self-Pay

$77

Average discount available for prompt cash payment at this facility.

Insurance Median

$150

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: $77 (1795%)

Insurance Median: $150 (3497%)

Cash: $77 (1795% of Medicare)

Ins. Median: $150 (3497% 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 3497% of the Medicare baseline (a markup of 3397%). 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
Healthcare Highways [2210]	$64 - $110	1492%
Hooray Health [8000]	$64	1492%
Oncology Patient Assistance Programs [2295]	$64	1492%
Oscar Insurance Company [7005]	$64	1492%
Osma Health Network [2345]	$64	1492%
Healthscope Benefits [2290]	$90	2098%
UnitedHealthcare	$90	2098%
Cigna	$100	2331%
National Association Of Letter Carriers [1695]	$100	2331%
Pba [1775]	$100	2331%
Resource One Administrators [2815]	$110	2564%
Web Tpa [2115]	$110	2564%
The Kempton Group Administrators [2905]	$115	2681%
Medica [2910]	$150	3497%
Multiplan [1680]	$150 - $204	3497%
Community Care [1290]	$191	4452%
Employee Benefit Management Services [2445]	$191	4452%
Phcs [1780]	$191 - $204	4452%
Administrative Concepts [1005]	$204	4755%
Allied Benefit Systems Inc [1030]	$204	4755%
Allied National Global Care [1035]	$204	4755%
Healthcost Solutions [2415]	$204	4755%
Healthfirst [2395]	$204	4755%
Hometown Health [2155]	$204	4755%
Mayo Clinic Health Solutions [2280]	$204	4755%
Mutual Of Omaha [1685]	$204	4755%
New Era Life Insurance Company [1705]	$204	4755%
Pan American Life Insurance Co [1770]	$204	4755%
Planned Administrators Inc [2360]	$204	4755%
Trustmark [2030]	$204	4755%
Universal Fidelity [2085]	$204	4755%

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 $77.
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 South 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.