CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: HCA Houston Healthcare West

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85610
  • Insurance Median: $5
  • Cash Discount Price: $620
  • vs. Medicare Baseline: 1.17x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at HCA Houston Healthcare West is $5. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $620. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 1.17x the Medicare baseline. Located in 12141 Richmond Ave, Houston, TX.
Cash / Self-Pay
$620

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: $620 (14452%)
Insurance Median: $5 (117%)
Cash: $620 (14452% 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 - $28 93%
American Health Plan $4 93%
Amerigroup $4 93%
Blue Cross Blue Shield $4 - $217 93%
Chc Harris Health $4 93%
Cigna $4 - $496 93%
Community Health Choice Mcd $4 93%
Devoted Health $4 93%
Humana $4 - $52 93%
Integranet Amerigroup Ipa $4 93%
Kelsey Seybold $4 93%
Molina Healthcare $4 - $9 93%
Oscar $4 - $12 93%
Procare Advantage $4 93%
Renaissance Ipa Radiology $4 93%
Shared Health $4 93%
Superior Health Plan $4 - $37 93%
Texas Childrens Health Plans $4 - $103 93%
Texas Health Network $4 93%
Triwest Healthcare Alliance $4 93%
United $4 - $279 93%
Van Lang Ipa $4 93%
Wellcare $4 93%
Wellmed $4 93%
Christus (Usfhp) $5 117%
Molina $5 117%
Provider Partners Health Plan Of Texas $5 117%
Triwest Health Alliance $5 117%
Universal Healthcare Group $5 117%
Community Health Choice $6 140%
Superior $6 - $7 140%
Verda Health Plan $6 140%
Corvel Corporation $8 186%
Omni Healthcare $9 210%
Healthcare Highways $12 280%
Texas Workforce Commission $149 3473%
Evry Health $169 3939%
Imagine Health $217 5058%
Healthsmart Preferred Care $267 - $527 6224%
Averde Health $279 6503%
Fidelis Securecare Of Tx $279 6503%
Coventry National First Health $330 7692%
Physicians Cooperative Of Texas $341 7949%
Rockport Workers Comp $341 7949%
Independent Medical System $372 8671%
National Healthcare Solutions $372 8671%
Southwest Medical $372 8671%
Triumph $372 8671%
Coastal Comp $403 9394%
Multiplan $465 - $527 10839%
Physicians, Inc $527 12284%
Affiliated Ppo $558 13007%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 12141 Richmond Ave, Houston, TX 77082
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals