CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: Hospital Pavia Arecibo

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85610
  • Insurance Median: $6
  • Cash Discount Price: $14
  • vs. Medicare Baseline: 1.40x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at Hospital Pavia Arecibo is $6. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $14. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 1.40x the Medicare baseline. Located in Carretera 129 Km.1 Avenida San Luis, Arecibo, PR.
Cash / Self-Pay
$14

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: $14 (326%)
Insurance Median: $6 (140%)
Cash: $14 (326% 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
First Medical $4 - $6 93%
Mso $4 - $5 93%
Plan Auxilio Mutuo $4 93%
Plan De Salud Menonita $4 - $9 93%
Auxilio Platino $5 117%
Ch $5 117%
Comerciales $5 117%
Hospicio $5 117%
Humana $5 - $9 117%
Mcs $5 - $9 117%
Medicare (plans) $5 117%
Tricare $5 117%
Triple S $5 - $9 117%
Va $5 117%
Mc $6 140%
Fondo Del Seguro Estado $7 163%
Prossam $7 163%
Acaa $8 186%
Aarp $9 210%
Bl $9 210%
Cigna $9 210%
Mapfre $9 210%
Privado $9 210%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: Carretera 129 Km.1 Avenida San Luis, Arecibo, PR 00612
  • CMS Rating: No CMS Rating
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals