CMS Price Transparency Data
Blood test, clotting time (PT/INR)
Facility: Saint Joseph Regional Medical Center
Billing Code: 85610 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 85610
- Insurance Median: $4
- Cash Discount Price: $66
- vs. Medicare Baseline: 0.93x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at Saint Joseph Regional Medical Center is $4. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $66. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 0.93x the Medicare baseline. Located in 5215 Holy Cross Pkwy, Mishawaka, IN.
Cash / Self-Pay
$66
Average discount available for prompt cash payment at this facility.
Insurance Median
$4
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: $66 (1538%)
Insurance Median: $4 (93%)
Cash: $66 (1538% of Medicare)
Ins. Median: $4 (93% 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
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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 | $2 - $279 | 47% |
| Blue Cross Blue Shield | $2 - $636 | 47% |
| Medicaid / KanCare | $2 - $93 | 47% |
| UnitedHealthcare | $2 - $180 | 47% |
| Bcn Domestic | $3 | 70% |
| Blue Benefit Administrators Of Massachusetts | $3 - $636 | 70% |
| Blue Care Network | $3 - $636 | 70% |
| Blue Distinction Transplant | $3 - $636 | 70% |
| Blue Shield - Ca | $3 - $636 | 70% |
| Blue Shield - Id (Regence) | $3 - $636 | 70% |
| Blue Shield - Ny Highmark Northeastern | $3 - $636 | 70% |
| Blue Shield - Ny Highmark Western | $3 - $636 | 70% |
| Blue Shield - Pa (Highmark) | $3 - $636 | 70% |
| Blue Shield - Wa (Regence) | $3 - $636 | 70% |
| Health Choices | $3 | 70% |
| Kaiser Domestic | $3 | 70% |
| Pre-Employment | $3 | 70% |
| Wc Domestic | $3 | 70% |
| Albany County Correctional Facility | $4 | 93% |
| Align Senior Care | $4 | 93% |
| Ally Align Care Adv | $4 | 93% |
| Ambetter / Centene | $4 | 93% |
| American Health Advantage Of Idaho | $4 | 93% |
| American Health Plan | $4 | 93% |
| Amish Mennonite | $4 | 93% |
| Andrie Inc | $4 | 93% |
| Ascension St. Vincent Public Safety Medical | $4 | 93% |
| Aurora Special Needs | $4 | 93% |
| Bcccp-Michigan | $4 | 93% |
| Bccp | $4 | 93% |
| Blue Care Network Advantage | $4 | 93% |
| Blue Shield - De (Highmark) Medciare Advantage | $4 | 93% |
| Bmc Healthnet | $4 | 93% |
| Breast Grant-Connecticut | $4 | 93% |
| Broward County Dept Of Health | $4 | 93% |
| California Health And Wellness | $4 | 93% |
| Cardinal Innovations Lme | $4 | 93% |
| Care Connections Of Northern Iowa | $4 | 93% |
| Care Dimensions | $4 | 93% |
| Care Improvement Plus | $4 | 93% |
| Care Oregon Ohp | $4 | 93% |
| Care Resources Pace | $4 | 93% |
| Careplus Health Plans | $4 | 93% |
| Cca - Zing Health | $4 | 93% |
| Cca Senior Care Options | $4 | 93% |
| Cencal Health Plan | $4 | 93% |
| Cenpatico | $4 | 93% |
| Central Valley Medical Services Corp Pace | $4 | 93% |
| Champion Health Plan Mcr Advantage | $4 | 93% |
| Champva | $4 | 93% |
| Chhuny | $4 | 93% |
| Childrens Comm Health Plan | $4 | 93% |
| Childrens Medical Services Title 19 | $4 | 93% |
| Christian Brother Services | $4 - $66 | 93% |
| Cigna | $4 - $65 | 93% |
| City Of Philadelphia | $4 | 93% |
| Clear Spring Health | $4 | 93% |
| Clover Health | $4 | 93% |
| Cmh Allegan County | $4 | 93% |
| Cmh Ausable Valley | $4 | 93% |
| Cmh Barry County | $4 | 93% |
| Cmh Bay-Arenac County | $4 | 93% |
| Cmh Berrien County | $4 | 93% |
| Cmh Cass County | $4 | 93% |
| Cmh Central Mi County | $4 | 93% |
| Cmh Clinton-Eaton-Ingham County | $4 | 93% |
| Cmh Detroit Wayne Integrated Health Network | $4 | 93% |
| Cmh Genesee County | $4 | 93% |
| Cmh Ionia County | $4 | 93% |
| Cmh Jackson County/Lifeways | $4 | 93% |
| Cmh Kalamazoo | $4 | 93% |
| Cmh Kent County | $4 | 93% |
| Cmh Lenawee County | $4 | 93% |
| Cmh Livingston County | $4 | 93% |
| Cmh Macomb | $4 | 93% |
| Cmh Misc | $4 | 93% |
| Cmh Monroe County | $4 | 93% |
| Cmh Montcalm County | $4 | 93% |
| Cmh Muskegon County | $4 | 93% |
| Cmh Newaygo County | $4 | 93% |
| Cmh North Country | $4 | 93% |
| Cmh Northern Lakes County | $4 | 93% |
| Cmh Oakland County | $4 | 93% |
| Cmh Ottawa County | $4 | 93% |
| Cmh Van Buren County | $4 | 93% |
| Cmh Washtenaw County | $4 | 93% |
| Cmh Wayne County/Carelink | $4 | 93% |
| Cmh Wayne Cty/Com Liv Svcs | $4 | 93% |
| Cmh West Mi County | $4 | 93% |
| Commonwealth Care Alliance | $4 | 93% |
| Community Benefit Health | $4 | 93% |
| Community Care Behavorial Health | $4 | 93% |
| Community Care Partners | $4 | 93% |
| Community Health Alliance | $4 | 93% |
| Community Health Choice | $4 | 93% |
| Community Pace At Home | $4 | 93% |
| Connections Csp | $4 | 93% |
| County Coroner | $4 - $187 | 93% |
| County Funding Generic | $4 | 93% |
| Covid19 Hrsa Uninsured Testing And Treatment Fund | $4 | 93% |
| Dean Wi Badgercare | $4 | 93% |
| Delaware County Department Of Health | $4 | 93% |
| Delaware First Health | $4 | 93% |
| Delta Dental Nj | $4 | 93% |
| Dph Tb Program | $4 | 93% |
| Dscc | $4 | 93% |
| East Greenbush Central School District | $4 | 93% |
| Eastpointe Lme | $4 | 93% |
| Eddy Senior Care-Pace | $4 | 93% |
| Eddy Seniorcare Pace | $4 | 93% |
| Elementcare | $4 | 93% |
| Evercare | $4 | 93% |
| Everence | $4 | 93% |
| Family Health Network | $4 | 93% |
| Freedom First Healthcare | $4 | 93% |
| Fresno County Ccs | $4 | 93% |
| Gateway Health Plan | $4 | 93% |
| Geha | $4 - $64 | 93% |
| Genesys Pace Of Genesee County | $4 | 93% |
| Genex Wc | $4 | 93% |
| Georgia Health Advantage | $4 | 93% |
| Ghc Scw Wi Badgercare | $4 | 93% |
| Gold Advantage | $4 | 93% |
| Gpa Croell Redi Mix | $4 | 93% |
| Harbor Health | $4 | 93% |
| Health America Advantra | $4 | 93% |
| Health Safety Net | $4 | 93% |
| Healthsmart Workers Comp | $4 | 93% |
| Healthy Blue Ne | $4 | 93% |
| Hennepin Health | $4 | 93% |
| Highmark Health Options Dual Plan | $4 | 93% |
| Hope Select Pace | $4 | 93% |
| Horizon Nj Total Care | $4 | 93% |
| Hudson Headwaters Pace | $4 | 93% |
| Humana | $4 | 93% |
| Huron Valley Pace | $4 | 93% |
| Id County Ada | $4 | 93% |
| Id County Canyon | $4 | 93% |
| Id County Cat Fund | $4 | 93% |
| Id County Other | $4 | 93% |
| Id County Payette | $4 | 93% |
| Idaho Dept Health And Wellfare | $4 | 93% |
| Idaho Womens Health Check | $4 | 93% |
| Indiana Breast Cervical Cancer | $4 | 93% |
| Inland Empire Health Plan | $4 | 93% |
| Innovative Integrated Health Community Plans | $4 | 93% |
| Intercommunity Health Ohp | $4 | 93% |
| Iowa Health Advantage | $4 | 93% |
| Iowa Total Care | $4 | 93% |
| Jag Source | $4 | 93% |
| Jai Medical System | $4 | 93% |
| Johns Hopkins Advantage Md | $4 | 93% |
| Kern Family Health Plan | $4 | 93% |
| Keystone First | $4 | 93% |
| Keystone First Chip | $4 | 93% |
| La Care Health Plan | $4 | 93% |
| Lakeland Care Inc | $4 | 93% |
| Lasso Healthcare Msa | $4 | 93% |
| Life St Marys Pace | $4 | 93% |
| Lifecircles Pace | $4 | 93% |
| Longevity Health Plan | $4 | 93% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $4 | 93% |
| Managed Health Services - Indiana | $4 | 93% |
| Martins Point Generations Advantage | $4 | 93% |
| Maryland Breast & Cervical Program | $4 | 93% |
| Maryland Healthy Smiles - Scion Dental | $4 | 93% |
| Maryland Physicians Care | $4 | 93% |
| Mass General Brigham Mcr Adv | $4 | 93% |
| Massachusetts Behavioral Health Partnership | $4 | 93% |
| Mdwise | $4 | 93% |
| Medi-Cal | $4 | 93% |
| Medi-Cal Healthnet | $4 | 93% |
| Medicare (plans) | $4 - $184 | 93% |
| Medipak Advantage | $4 | 93% |
| Medstar Dc Healthy Family | $4 | 93% |
| Medstar Md Health Choice | $4 | 93% |
| Mercy Life | $4 | 93% |
| Mercyone Cedar Valley | $4 | 93% |
| Meridian Complete | $4 - $180 | 93% |
| Meritain | $4 - $66 | 93% |
| Michigan Complete Health | $4 | 93% |
| Mo Home State Health Plan | $4 | 93% |
| Molina Centennial Care | $4 | 93% |
| Nascentia Health Options | $4 | 93% |
| Nascentia Health Plus | $4 | 93% |
| Nebraska Total Care | $4 | 93% |
| New Centry Health Careplus | $4 | 93% |
| New York Cancer Services Program | $4 | 93% |
| New York State Insurance Fund | $4 | 93% |
| Nextlevel Health | $4 | 93% |
| Njm Insurance Group | $4 | 93% |
| Oregon Screenwise | $4 | 93% |
| Osu Prime Care Advantage | $4 | 93% |
| Pace Cny | $4 | 93% |
| Pace Iowa Immanuel Pathways | $4 | 93% |
| Pace Of Southwest Michigan | $4 | 93% |
| Pace Southeast | $4 | 93% |
| Pace-Trinity Health | $4 - $180 | 93% |
| Paramount Advantage | $4 | 93% |
| Parkland Community Health Plan | $4 | 93% |
| Partners Behavioral Lme | $4 | 93% |
| Peach State Healthplan | $4 | 93% |
| Peak Pace Solutions | $4 | 93% |
| Perennial Advantage | $4 | 93% |
| Philadelphia County Funding | $4 | 93% |
| Preferred Care Partners | $4 | 93% |
| Preferred One | $4 - $66 | 93% |
| Presbyterian Centennial Care | $4 | 93% |
| Presbyterian Senior Plan | $4 | 93% |
| Prestige Health Choice | $4 | 93% |
| Priority Partners | $4 | 93% |
| Provider Partners Health Plan Of Illinois | $4 | 93% |
| Pruitthealth Premier | $4 | 93% |
| Reliance Community Care Partners Care Resources Pace | $4 | 93% |
| Robert F Sing Program | $4 | 93% |
| Rx 340B Pass Along | $4 | 93% |
| Rx Allwin | $4 | 93% |
| Rx Assistance/Rx Manufacturer Assistance 0 Copay | $4 | 93% |
| Rx Grane Grnmedd | $4 | 93% |
| Rx Heatlhcomp | $4 | 93% |
| Rx Medi-Cal | $4 | 93% |
| Rx Meridian Rx | $4 | 93% |
| Rx Restat | $4 | 93% |
| Rx Retiree Rx Care | $4 | 93% |
| Rx Saif Opdp Wc | $4 | 93% |
| Rx Worker'S Comp | $4 | 93% |
| Ryan White Florida Mssrp | $4 | 93% |
| Sandhills Center Lme | $4 | 93% |
| Scan Health Plan Mcr Ipa Meritage Oon | $4 | 93% |
| Screening For Life | $4 | 93% |
| Secure Horizons Ma Pffs | $4 | 93% |
| Serenity Pace | $4 | 93% |
| Siouxland Pace | $4 | 93% |
| Solis Health Plans | $4 | 93% |
| St Joseph County Hlth Dpt | $4 - $270 | 93% |
| Stephenson Cty Health | $4 | 93% |
| Sunnyview-Pace Finance Dept | $4 | 93% |
| Sunshine State Health Plan | $4 | 93% |
| Superior Health | $4 | 93% |
| Tenncare | $4 | 93% |
| Texan Plus | $4 | 93% |
| Texas Children'S Health Plan | $4 | 93% |
| The Health Plan | $4 | 93% |
| Thome Pace | $4 | 93% |
| Todays Options | $4 | 93% |
| Tribute Health Plans | $4 | 93% |
| Tricare | $4 | 93% |
| Trillium Community Ohp | $4 | 93% |
| Triwest Health Alliance | $4 | 93% |
| Tufts Health Public Plans | $4 | 93% |
| Um Health Advantage | $4 | 93% |
| Union Health Service | $4 | 93% |
| Us Family Health Plan | $4 | 93% |
| Vaya Health Lme | $4 | 93% |
| Veterans Administration | $4 | 93% |
| Veterans Eval Services | $4 | 93% |
| Washtenaw Health Plan | $4 | 93% |
| Wc Accident Fund | $4 | 93% |
| Wc Ace | $4 | 93% |
| Wc Acs Federal Employees | $4 | 93% |
| Wc Acuity | $4 | 93% |
| Wc Advantage | $4 | 93% |
| Wc Aegis | $4 | 93% |
| Wc Aig | $4 | 93% |
| Wc Aims | $4 | 93% |
| Wc Alaska National Ins | $4 | 93% |
| Wc Align Network | $4 - $101 | 93% |
| Wc Allied | $4 | 93% |
| Wc Am Trust N America | $4 | 93% |
| Wc American Claims Mgmt | $4 | 93% |
| Wc Amerisure | $4 | 93% |
| Wc Amtrust | $4 | 93% |
| Wc Asu Risk Mgt | $4 | 93% |
| Wc Benetech | $4 | 93% |
| Wc Berkley Admin | $4 | 93% |
| Wc Broadspire | $4 | 93% |
| Wc Broward County | $4 | 93% |
| Wc Bunch & Associates | $4 | 93% |
| Wc California State Comp Ins | $4 | 93% |
| Wc California State Ins Fund | $4 | 93% |
| Wc Capitol Area Health Consortium | $4 | 93% |
| Wc Ccmsi | $4 | 93% |
| Wc Chartis | $4 | 93% |
| Wc Chubb | $4 | 93% |
| Wc Cirma | $4 | 93% |
| Wc City Of Albany | $4 | 93% |
| Wc City Of Sioux City | $4 | 93% |
| Wc Claims Mgmt Inc | $4 | 93% |
| Wc Cna | $4 | 93% |
| Wc Comp One Admin C/O Manageability | $4 | 93% |
| Wc Compone Admin | $4 | 93% |
| Wc Corvel | $4 | 93% |
| Wc Ct Healthcare Trust | $4 | 93% |
| Wc Donegal Insurance Group | $4 | 93% |
| Wc Emc Insurance Company | $4 | 93% |
| Wc Employee Mutual | $4 | 93% |
| Wc Enablecomp | $4 | 93% |
| Wc Erie | $4 | 93% |
| Wc Esis | $4 | 93% |
| Wc Evolutions | $4 | 93% |
| Wc Fcci | $4 | 93% |
| Wc Fed Ex | $4 | 93% |
| Wc Federal Black Lung | $4 | 93% |
| Wc Federated | $4 | 93% |
| Wc Finley Occupational Health | $4 | 93% |
| Wc First Agency/Occunet | $4 | 93% |
| Wc Ford Motor | $4 | 93% |
| Wc Fresno Unified Emp | $4 | 93% |
| Wc Gallagher Bassett | $4 | 93% |
| Wc General Motors | $4 | 93% |
| Wc Generic | $4 | 93% |
| Wc Genex Care For Ohio | $4 | 93% |
| Wc Great West Casualty | $4 | 93% |
| Wc Guarantee Insurance | $4 | 93% |
| Wc Guard Insurance Company | $4 | 93% |
| Wc Hab | $4 | 93% |
| Wc Hartford | $4 | 93% |
| Wc Hastings | $4 | 93% |
| Wc Health Management | $4 | 93% |
| Wc Heritage Summit | $4 | 93% |
| Wc Hireright | $4 | 93% |
| Wc Horizon | $4 | 93% |
| Wc Icw Group | $4 | 93% |
| Wc Idaho State Ins Fund | $4 | 93% |
| Wc Intercare Insurance | $4 | 93% |
| Wc Intermountain | $4 | 93% |
| Wc Johns Eastern | $4 | 93% |
| Wc Kemberton | $4 | 93% |
| Wc Key Ins & Benefit Solutions | $4 | 93% |
| Wc Liberty Mutual | $4 | 93% |
| Wc Mac Risk Management | $4 | 93% |
| Wc Massachusetts | $4 | 93% |
| Wc Mdia | $4 | 93% |
| Wc Meadowbrook Claim | $4 | 93% |
| Wc Medical Administrators | $4 | 93% |
| Wc Meijers | $4 | 93% |
| Wc Memic | $4 | 93% |
| Wc Mercy Workcare | $4 | 93% |
| Wc Michigan | $4 | 93% |
| Wc Michigan Millers Mutual | $4 | 93% |
| Wc Mitchell Frankenmuth | $4 | 93% |
| Wc Mra | $4 | 93% |
| Wc Nationwide | $4 | 93% |
| Wc Nca Comp | $4 | 93% |
| Wc New York | $4 | 93% |
| Wc New York Special Funds | $4 | 93% |
| Wc North American Rishces | $4 | 93% |
| Wc Northeast Health | $4 | 93% |
| Wc Notre Dame | $4 - $56 | 93% |
| Wc Novanet | $4 | 93% |
| Wc O'Hara Corp | $4 | 93% |
| Wc Occ Health Allen | $4 | 93% |
| Wc Ohio Bureau | $4 | 93% |
| Wc One Call Medical | $4 | 93% |
| Wc Paradigm | $4 | 93% |
| Wc Peerless | $4 | 93% |
| Wc Pma | $4 | 93% |
| Wc Praxis Health Network | $4 | 93% |
| Wc Price Chopper | $4 | 93% |
| Wc Procura Management | $4 | 93% |
| Wc Qualcare | $4 | 93% |
| Wc Quiktrip | $4 | 93% |
| Wc Reny Company | $4 | 93% |
| Wc Rev Claims | $4 | 93% |
| Wc Risico | $4 | 93% |
| Wc Rural Mutual | $4 | 93% |
| Wc Saif Oregon | $4 | 93% |
| Wc Secura | $4 | 93% |
| Wc Sedgwick | $4 | 93% |
| Wc Sentry | $4 | 93% |
| Wc Sheakley Unicomp | $4 | 93% |
| Wc Smile Lodge | $4 | 93% |
| Wc Society | $4 | 93% |
| Wc Srs | $4 | 93% |
| Wc Taconic (Mro) | $4 | 93% |
| Wc Taconic Farms | $4 | 93% |
| Wc Travelers | $4 | 93% |
| Wc Triad Group | $4 | 93% |
| Wc Tristar | $4 | 93% |
| Wc Troy Ny | $4 | 93% |
| Wc Tyson | $4 | 93% |
| Wc Unified Health Services | $4 | 93% |
| Wc United Heartland | $4 | 93% |
| Wc Us Dept Of Labor | $4 | 93% |
| Wc Velocity | $4 | 93% |
| Wc Walmart | $4 | 93% |
| Wc West Bend | $4 | 93% |
| Wc West Bend Mutual/Argent | $4 | 93% |
| Wc Winnebago Industries | $4 | 93% |
| Wc Yankee Trails | $4 | 93% |
| Wc York Risk | $4 | 93% |
| Wc Zenith | $4 | 93% |
| Wc Zurich | $4 | 93% |
| Welbe Health | $4 | 93% |
| Wellmed | $4 | 93% |
| Wellsense Health Plan | $4 | 93% |
| Wi Womens Wellness | $4 | 93% |
| Allied Benefit Systems | $5 - $342 | 117% |
| Ameriben | $5 - $61 | 117% |
| Auxiant | $5 - $388 | 117% |
| Benefit Administrative Systems,Llc | $5 | 117% |
| Custom Design Benefits | $5 - $388 | 117% |
| Encore Health | $5 - $63 | 117% |
| Key Benefit Administrator | $5 - $388 | 117% |
| Luminare Health (Detroit) | $5 - $61 | 117% |
| Physicians Health Plan Northern Indiana Health Insurance | $5 - $544 | 117% |
| Provider Partners Health Plan Of Indiana | $5 - $198 | 117% |
| Sagamore Health Network | $5 - $75 | 117% |
| Signature Care | $5 - $81 | 117% |
| Caresource | $6 - $279 | 140% |
| Siho Insurance Services | $7 - $288 | 163% |
| Phcs | $8 | 186% |
| Plain Church Group | $9 - $27 | 210% |
| Wc Encore Health Network | $9 | 210% |
| Hospice Of Marshall County | $26 | 606% |
| Hospice Of St Joseph County | $26 | 606% |
| Notre Dame Athletic Association | $56 | 1305% |
| Indiana Criminal Justice Inst | $63 | 1469% |
| Western & Southern Financial Group | $63 | 1469% |
| Healthscope | $64 | 1492% |
| Student Insurance Cma | $64 | 1492% |
| Group Administrators | $65 | 1515% |
| Health Partners | $65 | 1515% |
| Mvp | $65 | 1515% |
| Prairie States | $65 | 1515% |
| Priority Health | $65 | 1515% |
| Professional Benefit Administrators | $65 | 1515% |
| Sisco Benefits | $65 | 1515% |
| Unified Group Services | $65 | 1515% |
| Asr Health Benefits | $66 | 1538% |
| Employee Benefit Management | $66 | 1538% |
| Medical Mutual | $66 | 1538% |
| Rural Carrier Health Benefit Plan | $66 | 1538% |
| Webtpa | $66 | 1538% |
| Goshen Preferred Network | $78 - $87 | 1818% |
| Christian Brothers Holy Cross | $81 | 1888% |
| Bankers Life Casualty | $101 | 2354% |
| Bureau Of Disability | $101 | 2354% |