CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: Physicians Regional Medical Center

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85610
  • Insurance Median: $5
  • Cash Discount Price: $38
  • vs. Medicare Baseline: 1.17x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at Physicians Regional Medical Center is $5. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $38. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 1.17x the Medicare baseline. Located in 7565 Dannaher Way Powell, Powell, TN.
Cash / Self-Pay
$38

Average discount available for prompt cash payment at this facility.

Insurance Median
$5

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: $38 (886%)
Insurance Median: $5 (117%)
Cash: $38 (886% of Medicare)
Ins. Median: $5 (117% 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 - $4 47%
Amerigroup Community Care $2 47%
Medicaid / KanCare $2 47%
UnitedHealthcare $2 - $172 47%
Aetna $4 - $14 93%
Blue Cross Blue Shield $4 - $33 93%
Department Of Veterans Affairs $4 93%
Humana $4 93%
Medicare (plans) $4 93%
Node Bluecare Plus Tn Mcr Adv $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%
Tricare $4 93%
Veterans Eval Services $4 93%
Wellcare $4 93%
Node Nhc Mcr Adv $5 117%
Node Us Dept Of Labor $5 117%
Us Department Of Labor $5 117%
Novanet Work Comp Tn $6 140%
Occunet Work Comp Tn $6 140%
Tn Work Comp $6 140%
Cigna $7 163%
Ambetter / Centene $8 186%
Node Point Comfort Underwriters $8 186%
Self Pay $37 - $39 862%
Multiplan $93 - $122 2168%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 7565 Dannaher Way Powell, Powell, TN 37849
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals