CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: Hospital Metropolitano Dr Susoni

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85610
  • Insurance Median: $8
  • Cash Discount Price: $20
  • vs. Medicare Baseline: 1.86x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at Hospital Metropolitano Dr Susoni is $8. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $20. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 1.86x the Medicare baseline. Located in Calle Palma Num 55, Arecibo, PR.
Cash / Self-Pay
$20

Average discount available for prompt cash payment at this facility.

Insurance Median
$8

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: $20 (466%)
Insurance Median: $8 (186%)
Cash: $20 (466% of Medicare)
Ins. Median: $8 (186% 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
Aetna $5 117%
Mcs $5 - $12 117%
Tricare $5 117%
Triple S $5 - $9 117%
Ch $6 140%
Comerciales $6 140%
Humana $6 - $9 140%
Medicare (plans) $6 140%
Mso $6 140%
Va $6 140%
Prossam $7 163%
Aarp $9 210%
Bl $9 210%
First Medical $9 210%
Hospicio $9 210%
Plan De Salud Menonita $9 210%
Cigna $10 233%
Mapfre $10 233%
Mc $12 280%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: Calle Palma Num 55, Arecibo, PR 00612
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals