CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: Johnson Memorial Hospital

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85610
  • Insurance Median: $8
  • Cash Discount Price: $15
  • vs. Medicare Baseline: 1.86x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at Johnson Memorial Hospital is $8. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $15. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 1.86x the Medicare baseline. Located in 201 Chestnut Hill Road, Stafford Springs, CT.
Cash / Self-Pay
$15

Average discount available for prompt cash payment at this facility.

Insurance Median
$8

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: $15 (350%)
Insurance Median: $8 (186%)
Cash: $15 (350% of Medicare)
Ins. Median: $8 (186% 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 - $9 93%
Blue Cross Blue Shield $4 - $8 93%
Cca Senior Care Options $4 93%
Cigna $4 - $24 93%
Geha $4 93%
Harvard Pilgrim Healthcare $4 93%
Medicare (plans) $4 93%
UnitedHealthcare $4 - $27 93%
Centivo $5 117%
Fallon Health $6 140%
Connecticare $7 163%
Bcn Domestic $8 186%
Blue Benefit Administrators Of Massachusetts $8 186%
Blue Care Network $8 186%
Blue Distinction Transplant $8 186%
Blue Shield - Ca $8 186%
Blue Shield - Id (Regence) $8 186%
Blue Shield - Ny Highmark Northeastern $8 186%
Blue Shield - Ny Highmark Western $8 186%
Blue Shield - Pa (Highmark) $8 186%
Blue Shield - Wa (Regence) $8 186%
Health Choices $8 186%
Kaiser Domestic $8 186%
Pre-Employment $8 186%
Unicare $8 186%
Wc Domestic $8 186%
Wellpoint $8 186%
1199 National Benefit Fund $9 210%
Allied Benefit Systems $9 210%
Claimdoc $9 210%
Connecticut Dept Of Correction $9 210%
Diversified Administrators $9 210%
Gravie Admin Services $9 210%
Hap $9 210%
Innovative Health Plan Ii $9 210%
Luminare Health $9 210%
Meritain $9 210%
Nippon Life Ins $9 210%
Webtpa $9 210%
Health New England $18 420%
Allied National Global Care $22 513%
Asrm - Reliance Standard Life Insurance $22 513%
Christian Care Ministry $22 513%
Dean Health $22 513%
Family Life Insurance Company $22 513%
Ghc Scw $22 513%
International Benefit Administrators $22 513%
Lifetime Benefit Solutions $22 513%
Manhattan Life $22 513%
Medi Share $22 513%
Multiplan $22 513%
Mvp $22 513%
Pai $22 513%
Pan-American Life $22 513%
Paramount Hmo $22 513%
Phcs $22 513%
Prime Health Services $22 513%
Trinity Health Share $22 513%
Health Smart $23 536%
Allegiance $24 559%
Health Partners $24 559%
Magnacare $24 559%
United Behavioral Health Eap $27 629%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 201 Chestnut Hill Road, Stafford Springs, CT 06076
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals