CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: Indiana Regional Medical Center

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85610
  • Insurance Median: $6
  • Cash Discount Price: $24
  • vs. Medicare Baseline: 1.40x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at Indiana Regional Medical Center is $6. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $24. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 1.40x the Medicare baseline. Located in 835 Hospital Road, Indiana, PA.
Cash / Self-Pay
$24

Average discount available for prompt cash payment at this facility.

Insurance Median
$6

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: $24 (559%)
Insurance Median: $6 (140%)
Cash: $24 (559% of Medicare)
Ins. Median: $6 (140% 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.

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
Highmark $3 - $13 70%
Highmark Wholecare $3 - $4 70%
Aetna $4 - $13 93%
Ambetter / Centene $4 - $5 93%
Amerihealth Caritas $4 - $5 93%
Cigna $4 - $14 93%
Geisinger Health Plan $4 - $5 93%
Humana $4 93%
Medicare (plans) $4 93%
Tricare $4 - $69 93%
United Mine Workers Of America $4 93%
UnitedHealthcare $4 - $28 93%
Upmc Health Plan $4 - $32 93%
Geisinger $6 - $12 140%
Pa Health And Wellness Commercial $6 - $12 140%
Department Of Human Services And Torrance State Hospital $39 - $43 909%
Premier Comp Solutions, Llc $56 - $62 1305%
Miscellaneous Commercial $62 - $69 1445%
Pa Workers Compensation $62 - $69 1445%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 835 Hospital Road, Indiana, PA 15701
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals