CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: Medical Center Hospital

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85610
Insurance Median: $11
Cash Discount Price: $76
vs. Medicare Baseline: 2.56x Medicare

The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at Medical Center Hospital is $11. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $76. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 2.56x the Medicare baseline. Located in 500 W 4Th Street, Odessa, TX.

Cash / Self-Pay

$76

Average discount available for prompt cash payment at this facility.

Insurance Median

$11

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: $76 (1772%)

Insurance Median: $11 (256%)

Cash: $76 (1772% of Medicare)

Ins. Median: $11 (256% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 256% of the Medicare baseline (a markup of 156%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Geha	$2	47%
UnitedHealthcare	$2 - $118	47%
Corvel Wc	$3	70%
Aetna	$4 - $78	93%
Ambetter / Centene	$4	93%
Amerigroup	$4	93%
Blue Cross Blue Shield	$4 - $51	93%
Care Improvement Plus	$4	93%
Community Health Choice	$4	93%
First Care Health Plan	$4	93%
Humana	$4	93%
Medicaid / KanCare	$4	93%
Novitas Solutions	$4	93%
Superior Chips	$4	93%
Superior Health Plan	$4	93%
Triwest Va Ccn	$4	93%
Wellcare By Allwell	$4	93%
Group Resources	$5	117%
Workers Comp	$9	210%
Health Select	$12 - $51	280%
90 Degree Benefits	$14 - $57	326%
Caprock	$17 - $20	396%
Cigna	$18 - $60	420%
Healthsmart Preferred Care	$19 - $71	443%
State Comptroller	$59	1375%
Texas Mutual Wc	$78	1818%
Firstcare	$83	1935%

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 $76.
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 Medical Center 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.