CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: Mount Sinai Rehabilitation Hospital Inc

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85610
  • Insurance Median: $17
  • Cash Discount Price: $15
  • vs. Medicare Baseline: 3.96x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at Mount Sinai Rehabilitation Hospital Inc is $17. 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 3.96x the Medicare baseline. Located in 490 Blue Hills Ave, Hartford, CT.
Cash / Self-Pay
$15

Average discount available for prompt cash payment at this facility.

Insurance Median
$17

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: $17 (396%)
Cash: $15 (350% of Medicare)
Ins. Median: $17 (396% 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 396% of the Medicare baseline (a markup of 296%). 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
Aetna $4 - $6 93%
Blue Cross Blue Shield $4 - $17 93%
Cca Senior Care Options $4 93%
Cigna $4 - $5 93%
Geha $4 93%
Harvard Pilgrim Healthcare $4 93%
Medicare (plans) $4 93%
UnitedHealthcare $4 93%
Allegiance $5 117%
Health Partners $5 117%
Magnacare $5 117%
1199 National Benefit Fund $6 140%
Allied Benefit Systems $6 140%
Gravie Admin Services $6 140%
Hap $6 140%
Luminare Health $6 140%
Meritain $6 140%
Nippon Life Ins $6 140%
Webtpa $6 140%
Claimdoc $9 210%
Diversified Administrators $9 210%
Innovative Health Plan Ii $9 210%
Connecticut Dept Of Correction $12 280%
Health New England $14 326%
Bcn Domestic $17 396%
Blue Benefit Administrators Of Massachusetts $17 396%
Blue Care Network $17 396%
Blue Distinction Transplant $17 396%
Blue Shield - Ca $17 396%
Blue Shield - Id (Regence) $17 396%
Blue Shield - Ny Highmark Northeastern $17 396%
Blue Shield - Ny Highmark Western $17 396%
Blue Shield - Pa (Highmark) $17 396%
Blue Shield - Wa (Regence) $17 396%
Health Choices $17 396%
Kaiser Domestic $17 396%
Pre-Employment $17 396%
Unicare $17 396%
Wc Domestic $17 396%
Allied National Global Care $18 420%
Asrm - Reliance Standard Life Insurance $18 420%
Christian Care Ministry $18 420%
Dean Health $18 420%
Family Life Insurance Company $18 420%
Ghc Scw $18 420%
International Benefit Administrators $18 420%
Lifetime Benefit Solutions $18 420%
Manhattan Life $18 420%
Medi Share $18 420%
Multiplan $18 420%
Mvp $18 420%
Pai $18 420%
Pan-American Life $18 420%
Paramount Hmo $18 420%
Phcs $18 420%
Trinity Health Share $18 420%
Connecticare $22 - $24 513%
Prime Health Services $22 513%
Health Smart $23 536%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 490 Blue Hills Ave, Hartford, CT 06112
  • CMS Rating: No CMS Rating
  • Ownership Type: N/A
  • Hospital Type: PART A PROVIDER - HOSPITAL