CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: Hill Country Memorial Hospital

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85610
  • Insurance Median: $5
  • Cash Discount Price: $327
  • vs. Medicare Baseline: 1.17x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at Hill Country Memorial Hospital is $5. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $327. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 1.17x the Medicare baseline. Located in 1020 South State Highway 16, Fredericksburg, TX.
Cash / Self-Pay
$327

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: $327 (7622%)
Insurance Median: $5 (117%)
Cash: $327 (7622% 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
Aetna $4 - $164 93%
Blue Cross Blue Shield $4 - $96 93%
Community First Health Plans $4 - $88 93%
Gonzaba Medical Group $4 93%
Ilumed $4 93%
Molina Healthcare $4 - $7 93%
Superior Health $4 - $16 93%
Triwest $4 93%
United $4 - $147 93%
Wellcare $4 93%
Wellmed $4 93%
Triwest Health Alliance $5 117%
Cigna $7 - $9 163%
Superior $7 163%
Healthcare Highways $10 233%
Healthsmart Preferred Care $180 4196%
Multiplan $245 - $278 5711%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1020 South State Highway 16, Fredericksburg, TX 78624
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals