CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: HCA Houston Healthcare Medical Center

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85610
  • Insurance Median: $5
  • Cash Discount Price: $314
  • vs. Medicare Baseline: 1.17x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at HCA Houston Healthcare Medical Center is $5. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $314. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 1.17x the Medicare baseline. Located in 1313 Hermann Dr, Houston, TX.
Cash / Self-Pay
$314

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: $314 (7319%)
Insurance Median: $5 (117%)
Cash: $314 (7319% 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
United $3 - $359 70%
Aetna $4 - $28 93%
American Health Plan $4 93%
Blue Cross Blue Shield $4 - $279 93%
Cigna $4 - $23 93%
Community Health Choice Mcd $4 93%
Devoted Health $4 93%
Evry Health $4 - $218 93%
Humana $4 - $52 93%
Integranet Amerigroup Ipa $4 93%
Molina Healthcare $4 - $9 93%
Oscar $4 - $12 93%
Procare Advantage $4 93%
Shared Health $4 93%
Superior Health Plan $4 - $48 93%
Triwest Healthcare Alliance $4 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%
Community Health Choice $6 140%
Superior $6 - $7 140%
Verda Health Plan $6 140%
Coventry National First Health $8 - $425 186%
Healthcare Highways $12 280%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1313 Hermann Dr, Houston, TX 77004
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals