CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: Lonesome Pine Hospital

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85610
  • Insurance Median: $5
  • Cash Discount Price: $7
  • vs. Medicare Baseline: 1.17x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at Lonesome Pine Hospital is $5. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $7. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 1.17x the Medicare baseline. Located in 1990 Holton Avenue East, Big Stone Gap, VA.
Cash / Self-Pay
$7

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: $7 (163%)
Insurance Median: $5 (117%)
Cash: $7 (163% 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
Amerigroup $2 - $4 47%
UnitedHealthcare $3 - $5 70%
Aetna $4 - $20 93%
Blue Cross Blue Shield $4 - $46 93%
Cigna $4 - $16 93%
Devoted Health Plan $4 93%
Humana $4 93%
Managed Medicaire $4 93%
Medicare (plans) $4 93%
Molina Healthcare $4 - $5 93%
Mountain Empire Pace $4 93%
Nhc Advantage $4 93%
Sentara Health $4 - $12 93%
United Mine Workers Of America $4 93%
Optima Health $5 117%
Wellcare $5 117%
Ambetter / Centene $9 210%
Seven Corners, Inc. $10 233%
Medcost $22 513%
First Health Coventry $41 956%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1990 Holton Avenue East, Big Stone Gap, VA 24219
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals