CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: Saint Mary's Hospital

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85610
  • Insurance Median: $8
  • Cash Discount Price: $19
  • vs. Medicare Baseline: 1.86x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at Saint Mary's Hospital is $8. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $19. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 1.86x the Medicare baseline. Located in 56 Franklin Street, Waterbury, CT.
Cash / Self-Pay
$19

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: $19 (443%)
Insurance Median: $8 (186%)
Cash: $19 (443% 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 - $8 93%
Blue Cross Blue Shield $4 - $5 93%
Cca Senior Care Options $4 93%
Cigna $4 - $27 93%
Geha $4 93%
Harvard Pilgrim Healthcare $4 93%
Medicare (plans) $4 93%
UnitedHealthcare $4 - $34 93%
Bcn Domestic $5 117%
Blue Benefit Administrators of Massachusetts $5 117%
Blue Care Network $5 117%
Blue Distinction Transplant $5 117%
Blue Shield - Ca $5 117%
Blue Shield - Id (Regence) $5 117%
Blue Shield - Ny Highmark Northeastern $5 117%
Blue Shield - Ny Highmark Western $5 117%
Blue Shield - PA (Highmark) $5 117%
Blue Shield - Wa (Regence) $5 117%
Centivo $5 117%
Connecticare $5 117%
Health Choices $5 117%
Kaiser Domestic $5 117%
Pre-Employment $5 117%
Unicare $5 117%
Wc Domestic $5 117%
Wellpoint $5 117%
1199 National Benefit Fund $8 186%
Allegiance $8 186%
Allied Benefit Systems $8 186%
Gravie Admin Services $8 186%
Hap $8 186%
Health Partners $8 186%
Luminare Health $8 186%
Magnacare $8 186%
Meritain $8 186%
Nippon Life Ins $8 186%
Webtpa $8 186%
Claimdoc $9 210%
Connecticut Dept of Correction $9 210%
Diversified Administrators $9 210%
Innovative Health Plan II $9 210%
Carelon Behavioral Health $17 396%
Health New England $18 420%
Allied National Global Care $26 606%
Asrm - Reliance Standard Life Insurance $26 606%
Christian Care Ministry $26 606%
Dean Health $26 606%
Fallon Health $26 606%
Family Life Insurance Company $26 606%
Ghc Scw $26 606%
International Benefit Administrators $26 606%
Lifetime Benefit Solutions $26 606%
Manhattan Life $26 606%
Medi Share $26 606%
Multiplan $26 606%
Mvp $26 606%
PHCS $26 606%
Pai $26 606%
Pan-American Life $26 606%
Paramount HMO $26 606%
Trinity Health Share $26 606%
Prime Health Services $27 629%
Health Smart $29 676%
United Behavioral Health Eap $34 793%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 56 Franklin Street, Waterbury, CT 06706
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals