CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: Blount Memorial Hospital

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85610
Insurance Median: $7
Cash Discount Price: $25
vs. Medicare Baseline: 1.63x Medicare

The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at Blount Memorial Hospital is $7. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $25. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 1.63x the Medicare baseline. Located in 907 E Lamar Alexander Parkway, Maryville, TN.

Cash / Self-Pay

$25

Average discount available for prompt cash payment at this facility.

Insurance Median

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: $25 (583%)

Insurance Median: $7 (163%)

Cash: $25 (583% of Medicare)

Ins. Median: $7 (163% 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.

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
Medicaid / KanCare	$2 - $7	47%
Cigna	$3 - $6	70%
Golden Rule Insurance Company [2991]	$3	70%
Mvp Health Care [3037]	$3	70%
Oxford Health Plans [2992]	$3	70%
UnitedHealthcare	$3 - $5	70%
Blue Cross Blue Shield	$4 - $20	93%
Humana	$4	93%
Medicare (plans)	$4	93%
Tricare	$4	93%
Ambetter / Centene	$7	163%
Consociate Health Contracted [4835]	$9	210%
Fairos/Occunet Contracted [4837]	$10	233%
Prisma Health Seniorcare Pace - Midlands [5400]	$19	443%
Prisma Health Seniorcare Pace-Upstate [5200]	$19	443%
Promise Health Plan Contracted [2401]	$29 - $49	676%
Orangeburg Senior Helping Center Pace [5401]	$33	769%
Bob Jones Univ-Pai [821]	$49	1142%
Preferred Administrators Contracted [2839]	$57	1329%
Medcost [2940]	$61 - $68	1422%
Atlantic Packaging Contracted [4833]	$62	1445%
Aps Healthcare System [2981]	$66	1538%
Multiplan/Phcs Contracted [2950]	$73	1702%
Aetna	$74	1725%
Meritain Health Contracted [2200]	$74	1725%
Nippon [2300]	$74	1725%
Vsp Vision Care [2986]	$74	1725%
First Health Contracted [2952]	$76	1772%
Furman Int/Allen University Student [2951]	$76	1772%
Quiktrip-First Health [3067]	$76	1772%

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 $25.
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 Blount Memorial 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.