CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: Lafollette Medical Center

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85610
  • Insurance Median: $4
  • Cash Discount Price: $52
  • vs. Medicare Baseline: 0.93x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at Lafollette Medical Center is $4. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $52. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 0.93x the Medicare baseline. Located in 923 East Central Avenue, La Follette, TN.
Cash / Self-Pay
$52

Average discount available for prompt cash payment at this facility.

Insurance Median
$4

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: $52 (1212%)
Insurance Median: $4 (93%)
Cash: $52 (1212% of Medicare)
Ins. Median: $4 (93% 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
Amerigroup $2 47%
Medicaid / KanCare $2 - $4 47%
UnitedHealthcare $2 - $172 47%
Aetna $4 - $107 93%
Blue Cross Blue Shield $4 - $30 93%
Humana $4 93%
Medicare (plans) $4 93%
Node Amerigroup Mcr Adv $4 93%
Node Blueadvantage Mcr Adv $4 93%
Node Bluecare Plus Tn Mcr Adv $4 93%
Node Champva $4 93%
Node Devoted Health Mcr Adv $4 93%
Node Farm Bureau Mcr Adv $4 93%
Node Healthspring Mcr Adv $4 93%
Node Hospice Non Par Agree $4 93%
Node Va $4 93%
Node Wellcare Mcr Adv $4 93%
Tricare $4 93%
Triwest $4 93%
Veterans Eval Services $4 93%
Wellcare $4 93%
Windsor Health Plan $4 93%
Node Nhc Mcr Adv $5 117%
Node Us Dept Of Labor $5 117%
Novanet Work Comp Tn $6 140%
Tn Work Comp $6 140%
Cigna $7 163%
Ambetter / Centene $8 186%
Bluecare $8 - $9 186%
Node Point Comfort Underwriters $9 210%
Self Pay $49 1142%
Multiplan Complementary $131 3054%
Beech Street Work Comp Tn $638 14872%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 923 East Central Avenue, La Follette, TN 37766
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals