CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: Alliancehealth Madill

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85610
  • Insurance Median: $59
  • Cash Discount Price: $70
  • vs. Medicare Baseline: 13.75x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at Alliancehealth Madill is $59. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $70. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 13.75x the Medicare baseline. Located in 901 S 5Th Ave, Madill, OK.
Cash / Self-Pay
$70

Average discount available for prompt cash payment at this facility.

Insurance Median
$59

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: $70 (1632%)
Insurance Median: $59 (1375%)
Cash: $70 (1632% of Medicare)
Ins. Median: $59 (1375% 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 1375% of the Medicare baseline (a markup of 1275%). 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
Coventry $2 - $198 47%
Node Va $2 - $191 47%
Self Pay $2 - $139 47%
Aetna $3 - $317 70%
Globalhealth $3 - $246 70%
Healthcare Highways $3 - $248 70%
Multiplan $3 - $309 70%
Phcs $3 - $277 70%
Cigna $4 - $337 93%
Evolutions Healthcare Systems $4 - $337 93%
First Health $4 - $325 93%
Humana $4 - $82 93%
Medicaid / KanCare $4 93%
Node Us Dept Of Labor $5 117%
Healthchoice $6 140%
UnitedHealthcare $7 - $83 163%
Blue Cross Blue Shield $12 - $84 280%
Preferred Community Choice Ppo $59 1375%
Medicare (plans) $82 1911%
Node Global Health Mcr Adv $82 1911%
Node Indian Health Service Managed Care $83 1935%
Node Champva $86 2005%
Tricare $86 2005%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 901 S 5Th Ave, Madill, OK 73446
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Critical Access Hospitals