Blood test, clotting time (PT/INR)
Facility: Mercy St Francis Hospital
Billing Code: 85610 (CPT)
- CPT Billing Code: 85610
- Insurance Median: $74
- Cash Discount Price: $53
- vs. Medicare Baseline: 17.25x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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 1725% of the Medicare baseline (a markup of 1625%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Blue Cross Blue Shield | $4 - $80 | 93% |
| Medicare (plans) | $4 - $29 | 93% |
| Aetna | $4 - $73 | 93% |
| Medicaid / KanCare | $4 - $43 | 93% |
| UnitedHealthcare | $6 - $78 | 140% |
| Medical Associates Health Contracted [320444] | $22 - $28 | 513% |
| Kindful Hospice Contracted [320434] | $22 - $28 | 513% |
| Acentra Health Contracted [320527] | $22 - $23 | 513% |
| Halo Hcr Inc Hospice [20432] | $22 - $28 | 513% |
| Humana | $22 - $74 | 513% |
| Indian Health Service Contracted [320198] | $22 - $28 | 513% |
| Mercy Hospice Okc [20252] | $22 - $28 | 513% |
| Cross Timbers Hospice [20098] | $22 - $28 | 513% |
| Cigna | $22 - $78 | 513% |
| Kindful Hospice [20434] | $22 - $28 | 513% |
| Qual Choice Contracted [320325] | $22 - $28 | 513% |
| Pace of the Ozarks Contracted [320518] | $22 - $28 | 513% |
| Dept of Veteran Affairs Contracted [320106] | $22 - $28 | 513% |
| Halo Hcr Inc Hospice Contracted [320432] | $22 - $28 | 513% |
| Mercy Mgd Behavioral Health Contracted [320259] | $22 - $28 | 513% |
| Elara Caring Aspire Hospice [20433] | $22 - $28 | 513% |
| Globalhealth Contracted [320145] | $22 - $28 | 513% |
| Cherokee Nation Health Serv Contracted [320066] | $22 - $28 | 513% |
| Provider Partners Health Plans Contracted [320450] | $22 - $28 | 513% |
| Healthscope Contracted [320182] | $28 - $37 | 653% |
| Tricare | $28 | 653% |
| Administrative Payor Contracted [320005] | $36 - $37 | 839% |
| Centivo Contracted [320505] | $37 - $48 | 862% |
| Ambetter / Centene | $42 - $43 | 979% |
| Home State Health Plan Contracted [320187] | $42 - $43 | 979% |
| Novasys Contracted [320285] | $42 - $43 | 979% |
| Healthlink Contracted [320179] | $53 - $78 | 1235% |
| Preferred Health Plan Contracted [320522] | $53 | 1235% |
| Workers Comp [20426] | $65 - $70 | 1515% |
| United Medical Resources Contracted [320454] | $73 - $76 | 1702% |
| Mercy Benefit Admin Contracted [320251] | $73 - $78 | 1702% |
| Auxiant Contracted [320462] | $73 - $78 | 1702% |
| Point C Contracted [320238] | $73 - $78 | 1702% |
| Evolutions Health Care Contracted [320124] | $77 - $78 | 1795% |
| First Health Contracted [320128] | $77 - $78 | 1795% |
| Health Systems Inc Contracted [320174] | $77 - $78 | 1795% |
| Aither Health Contracted [320449] | $77 - $78 | 1795% |
| Show-Me Health Administrators Contracted [320483] | $77 - $78 | 1795% |
| Imagine 360 Contracted [320494] | $77 - $78 | 1795% |
| Point C [20238] | $77 - $78 | 1795% |
| Benefit Management Contracted [320052] | $77 - $78 | 1795% |
| USA Managed Care Org Contracted [320429] | $77 - $78 | 1795% |
| Edison Health Solutions Contracted [320502] | $77 - $78 | 1795% |
| 90 Degree Benefits Contracted [320436] | $77 - $78 | 1795% |
| Multiplan Contracted [320270] | $77 - $78 | 1795% |
| Private Health Care Systems Contracted [320320] | $77 - $78 | 1795% |
| Yuzu Health Contracted [320521] | $77 - $78 | 1795% |
| Reflect Health Contracted [320492] | $77 - $78 | 1795% |
| Ebms Contracted [320493] | $77 - $78 | 1795% |
| Medica Contracted [320239] | $77 | 1795% |
| Insurance System Inc Contracted [320465] | $77 - $78 | 1795% |