CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: Southern Coos Hospital & Health Center

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85610
Insurance Median: $44
Cash Discount Price: $62
vs. Medicare Baseline: 10.26x Medicare

The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at Southern Coos Hospital & Health Center is $44. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $62. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 10.26x the Medicare baseline. Located in 900 11Th Street Se, Bandon, OR.

Cash / Self-Pay

$62

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: $62 (1445%)

Insurance Median: $44 (1026%)

Cash: $62 (1445% 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
Healthnet - All Plans	$2 - $10	47%
Tricare	$10 - $136	233%
Advanced Health - All Plans	$11 - $148	256%
Aetna	$11 - $211	256%
Atrio Mcr Adv - Allplans	$11 - $155	256%
Confederated Tribes - All Plans	$11 - $155	256%
Moda Mcr Adv	$11 - $155	256%
Pacific Source Mcr Adv	$11 - $155	256%
Cigna	$13 - $185	303%
Moda Health Plan - All Other Plans	$15 - $209	350%
Prov Netwrk Of America - All Plans	$15 - $211	350%
Three Rivers - All Plans	$15 - $211	350%
UnitedHealthcare	$15 - $211	350%
Blue Cross Blue Shield	$16 - $218	373%
First Choice - All Plans	$16 - $216	373%
First Health - All Plans	$16 - $223	373%
Multiplan - All Plans	$16 - $218	373%
Pacific Source - All Other Plans	$16 - $223	373%
Providence Preferred - All Plans	$16 - $223	373%

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 $62.
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 Southern Coos Hospital & Health Center 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.