Blood test, clotting time (PT/INR)
Facility: Mercy Hospital Columbus
Billing Code: 85610 (CPT)
- CPT Billing Code: 85610
- Insurance Median: $35
- Cash Discount Price: $31
- vs. Medicare Baseline: 8.16x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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 816% of the Medicare baseline (a markup of 716%). 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Medicare (plans) | $4 - $36 | 93% |
| UnitedHealthcare | $4 - $40 | 93% |
| Humana | $4 - $46 | 93% |
| Blue Cross Blue Shield | $4 - $35 | 93% |
| Medicaid / KanCare | $4 - $35 | 93% |
| Health Systems Inc Contracted [320174] | $21 | 490% |
| Insurance System Inc Contracted [320465] | $21 | 490% |
| Administrative Payor Contracted [320005] | $22 | 513% |
| Mercy Mgd Behavioral Health Contracted [320259] | $35 | 816% |
| Elara Caring Aspire Hospice [20433] | $35 | 816% |
| Dept Of Veteran Affairs Contracted [320106] | $35 | 816% |
| Cherokee Nation Health Serv Contracted [320066] | $35 | 816% |
| Home State Health Plan Contracted [320187] | $35 | 816% |
| Tricare | $35 | 816% |
| Globalhealth Contracted [320145] | $35 | 816% |
| Cigna | $35 | 816% |
| Aetna | $35 - $43 | 816% |
| Medical Associates Health Contracted [320444] | $35 | 816% |
| Centurion Of Missouri [20459] | $35 | 816% |
| Novasys Contracted [320285] | $35 | 816% |
| Kindful Hospice [20434] | $35 | 816% |
| Ambetter / Centene | $35 | 816% |
| Kindful Hospice Contracted [320434] | $35 | 816% |
| Provider Partners Health Plans Contracted [320450] | $35 | 816% |
| Pace Of The Ozarks Contracted [320518] | $35 | 816% |
| Halo Hcr Inc Hospice [20432] | $35 | 816% |
| Qual Choice Contracted [320325] | $35 | 816% |
| Mercy Hospice Okc [20252] | $35 | 816% |
| Indian Health Service Contracted [320198] | $35 | 816% |
| Halo Hcr Inc Hospice Contracted [320432] | $35 | 816% |
| Cross Timbers Hospice [20098] | $35 | 816% |
| Healthscope Contracted [320182] | $37 | 862% |
| Workers Comp [20426] | $38 - $41 | 886% |
| United Medical Resources Contracted [320454] | $40 - $46 | 932% |
| First Health Contracted [320128] | $43 | 1002% |
| American Healthcare Alliance Contracted [320020] | $43 | 1002% |
| Medica Contracted [320239] | $43 | 1002% |
| Mercy Benefit Admin Contracted [320251] | $43 - $46 | 1002% |
| Healthlink Contracted [320179] | $43 - $46 | 1002% |
| Federal Medical Center Contracted [320127] | $43 | 1002% |
| Preferred Health Plan Contracted [320522] | $43 | 1002% |
| Usa Managed Care Org Contracted [320429] | $43 | 1002% |
| Yuzu Health Contracted [320521] | $46 | 1072% |
| Show-Me Health Administrators Contracted [320483] | $46 | 1072% |
| Ebms Contracted [320493] | $46 | 1072% |
| 90 Degree Benefits Contracted [320436] | $46 | 1072% |
| Benefit Management Contracted [320052] | $46 | 1072% |
| Private Health Care Systems Contracted [320320] | $46 | 1072% |
| Ppo Plus Contracted [320310] | $46 | 1072% |
| Reflect Health Contracted [320492] | $46 | 1072% |
| Edison Health Solutions Contracted [320502] | $46 | 1072% |
| Auxiant Contracted [320462] | $46 | 1072% |
| Point C Contracted [320238] | $46 | 1072% |
| Imagine 360 Contracted [320494] | $46 | 1072% |
| Aither Health Contracted [320449] | $46 | 1072% |
Consumer Guidance & Cost Commentary
Mercy Hospital Columbus, located at 220 N Pennsylvania Avenue in Columbus, KS, provides a blood test for clotting time (PT/INR) with a cash median price of $31. This cash rate is notably lower than the facility's gross charge of $48 and the median negotiated rate of $35, which reflects the administrative costs and contract structures typical of in-network billing. For patients with high-deductible plans, paying the $31 cash rate may be more cost-effective than the $35 negotiated rate if their insurance coverage does not fully cover the service or if they have not yet met their deductible.
The facility is a voluntary non-profit Critical Access Hospital, and while the data does not include a specific facility rating, the pricing landscape shows significant variation among payers. The lowest negotiated rate observed across all payers is $4, while the highest is $46, with the median paid amount reaching $102. Given that the Medicare amount for this procedure is $4.29, the cash price of $31 represents a substantial discount compared to the full chargemaster but may still exceed the Medicare benchmark. Patients are encouraged to contact the hospital directly to confirm "self-pay" or "prompt-pay" discounts, which can further reduce the final out-of-pocket cost before any insurance claims are processed.