CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: Ascension Seton Medical Center Austin

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85610
  • Insurance Median: $5
  • Cash Discount Price: $75
  • vs. Medicare Baseline: 1.17x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at Ascension Seton Medical Center Austin is $5. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $75. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 1.17x the Medicare baseline. Located in 1201 W 38Th St, Austin, TX.
Cash / Self-Pay
$75

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: $75 (1748%)
Insurance Median: $5 (117%)
Cash: $75 (1748% 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
Aarp Mc Wellmed $4 93%
Addr Cancer Together $4 93%
Aetna $4 - $29 93%
Ambetter / Centene $4 - $8 93%
Blue Cross Blue Shield $4 - $20 93%
Connected Senior Care $4 93%
Covid Hrsa $4 93%
Cshcn Cidc $4 93%
Dell Chip/Chip Perinate $4 - $15 93%
Dell Star $4 - $15 93%
Devoted Health Mcr Replacement $4 93%
Humana $4 - $7 93%
Medicare (plans) $4 93%
Pphp Mcr Advantage $4 93%
Research Study $4 93%
Sendero Chap $4 93%
Smarthealth $4 93%
Superior Allwell $4 93%
Tricare $4 93%
Tx Independence Hp $4 93%
Uhcpcip $4 93%
UnitedHealthcare $4 - $15 93%
Wellcare Med Advantage $4 93%
Wellpoint Chip/Chip Perinate $4 93%
Wellpoint Star $4 - $15 93%
Wellpoint Star Kids $4 93%
Wellpoint Star Plus $4 - $15 93%
Champva $5 117%
Occunet $6 140%
Sendero Idealcare $8 186%
Cigna $9 210%
Seton Performance Plus $10 233%
Covenant Health $23 536%
Superior Star $79 - $88 1841%
Superior Star Foster $79 - $88 1841%
Superior Star Kids $79 - $88 1841%
Superior Star Plus $79 - $88 1841%
Superior Chip/Chip Perinate $89 - $99 2075%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1201 W 38Th St, Austin, TX 78705
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals