CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: Bay Area Hospital

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85610
Insurance Median: $44
Cash Discount Price: $46
vs. Medicare Baseline: 10.26x Medicare

The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at Bay Area Hospital is $44. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $46. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 10.26x the Medicare baseline. Located in 1775 Thompson Road, Coos Bay, OR.

Cash / Self-Pay

$46

Average discount available for prompt cash payment at this facility.

Insurance Median

$44

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: $46 (1072%)

Insurance Median: $44 (1026%)

Cash: $46 (1072% of Medicare)

Ins. Median: $44 (1026% 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 1026% of the Medicare baseline (a markup of 926%). 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
Aetna	$1 - $8	23%
Healthnet Mcaid	$4	93%
Southwest Oregon Ipa - All Plans	$4	93%
Healthnet Mcr Adv	$5	117%
Moda Hlth Mcr Adv	$5	117%
Moda Beacon - All Other Plans	$12	280%
Nasomah Hlth Grp - All Plans	$15 - $112	350%
Ods Ppo/Pos - All Plans	$17	396%
Providence Pebb	$17	396%
Pacificsource - All Plans	$21 - $159	490%
Moda Connexus/Synergy	$22 - $166	513%
Cigna	$23 - $172	536%
First Choice - All Plans	$23 - $170	536%
Providence - All Other Plans	$23 - $174	536%
Healthnet Comm- All Other Plans	$24 - $178	559%
UnitedHealthcare	$24 - $178	559%
Blue Cross Blue Shield	$90 - $670	2098%

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 $46.
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 Bay Area Hospital 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.