CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: Northwest Health - Starke

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85610
  • Insurance Median: $4
  • Cash Discount Price: $16
  • vs. Medicare Baseline: 0.93x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at Northwest Health - Starke is $4. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $16. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 0.93x the Medicare baseline. Located in 102 E Culver Rd, Knox, IN.
Cash / Self-Pay
$16

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: $16 (373%)
Insurance Median: $4 (93%)
Cash: $16 (373% 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

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
Lutheran $1 - $29 23%
Medpartners $1 - $36 23%
Self Pay $1 - $59 23%
Alpha Baking $2 - $49 47%
Physicians Health Plan $2 - $45 47%
Blue Cross Blue Shield $3 - $7 70%
Encore $3 - $94 70%
Php $3 - $65 70%
UnitedHealthcare $3 - $77 70%
Aetna $4 - $94 93%
Caresource $4 93%
Cigna $4 - $90 93%
Community Health Alliance $4 - $97 93%
Coventry First Health $4 - $94 93%
Humana $4 93%
In Dept Of Correction $4 93%
Lutheran Network $4 - $95 93%
Managed Health Services $4 - $9 93%
Medicaid / KanCare $4 93%
Medicare (plans) $4 93%
Mhs $4 93%
Multiplan Inc $4 - $97 93%
Node Champva $4 93%
Node Devoted Health Mcr Adv $4 93%
Node Hospice Non Par Agree $4 93%
Node Pphp Mcr Adv $4 93%
Node Va $4 93%
Ppom $4 - $102 93%
Sagamore Health Network $4 - $95 93%
Tricare $4 93%
Us Department Of Labor $5 117%
Indiana Workers Comp $9 210%
Encore Kba Epo $10 233%
Magnacare Ma $10 233%
Encore Kba Ppo $13 303%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 102 E Culver Rd, Knox, IN 46534
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals