CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: The Women's Hospital

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85610
  • Insurance Median: $6
  • Cash Discount Price: $71
  • vs. Medicare Baseline: 1.40x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at The Women's Hospital is $6. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $71. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 1.40x the Medicare baseline. Located in 4199 Gateway Blvd, Newburgh, IN.
Cash / Self-Pay
$71

Average discount available for prompt cash payment at this facility.

Insurance Median
$6

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: $71 (1655%)
Insurance Median: $6 (140%)
Cash: $71 (1655% of Medicare)
Ins. Median: $6 (140% 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
Amish $2 - $9 47%
Blue Cross Blue Shield $3 - $4 70%
Aetna $4 - $28 93%
Alliance Coal $4 - $84 93%
Caresource $4 93%
Caresource Hip $4 93%
Caresource In $4 93%
Chamber Care $4 - $16 93%
Humana $4 93%
Iu Health $4 - $60 93%
Mdwise Hip $4 93%
Meridian Health Il $4 93%
Mhs $4 93%
Mhs Behavioral $4 93%
Molina Il $4 93%
Molina Ky $4 93%
Molina Ky Dual $4 93%
Passport Molina Ky $4 - $28 93%
Patoka Valley Health Care (80/20 Plan) $4 93%
Patoka Valley Health Care (90/10 Plan) $4 93%
UnitedHealthcare $4 - $97 93%
Wellcare Ky $4 - $28 93%
Ambetter / Centene $5 - $7 117%
Allied National/Zelis - Freedom Plan $6 - $11 140%
Caresource Marketplace (Just4Me) $6 140%
Claimdoc $6 140%
Hst $6 140%
One Care $6 - $85 140%
Cigna $7 - $87 163%
Claritev (Formerly Phcs/Mulitplan) $7 - $83 163%
Encorecombined $7 - $85 163%
Encoreprime $7 - $82 163%
First Health/Coventry $7 - $89 163%
Healthlink $7 - $103 163%
Hope Trust $7 163%
Noncontracted $7 163%
Sagamore $7 - $87 163%
Self Pay $9 - $71 210%
Center Care $16 - $94 373%
Immergrun $50 1166%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 4199 Gateway Blvd, Newburgh, IN 47630
  • CMS Rating: ★★★★★
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals