CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: Intermountain Health St. Mary's Regional Hospital

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85610
  • Insurance Median: $23
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 5.36x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at Intermountain Health St. Mary's Regional Hospital is $23. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 5.36x the Medicare baseline. Located in 2635 N 7Th St, Grand Junction, CO.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$23

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%)
Insurance Median: $23 (536%)
Ins. Median: $23 (536% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 536% of the Medicare baseline (a markup of 436%). 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.

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
Geha $4 - $27 93%
Select Health $4 93%
UnitedHealthcare $4 - $27 93%
Blue Cross Blue Shield $10 - $12 233%
Monument Health $15 350%
Cigna $19 - $22 443%
Allegiance $21 - $22 490%
Aetna $23 - $27 536%
Kaiser Perm Ppo/Pos $24 - $25 559%
Meritain Health $25 - $26 583%
Humana $26 - $27 606%
Cofinity $27 629%
First Health Network $27 629%
Private Hlthcare Sys $28 - $29 653%
Public Employees Health $29 - $30 676%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2635 N 7Th St, Grand Junction, CO 81501
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals