CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: Rockcastle County Hospital, Inc.

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85610
  • Insurance Median: $84
  • Cash Discount Price: $74
  • vs. Medicare Baseline: 19.58x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at Rockcastle County Hospital, Inc. is $84. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $74. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 19.58x the Medicare baseline. Located in 145 Newcomb Avenue, Mount Vernon, KY.
Cash / Self-Pay
$74

Average discount available for prompt cash payment at this facility.

Insurance Median
$84

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: $74 (1725%)
Insurance Median: $84 (1958%)
Cash: $74 (1725% of Medicare)
Ins. Median: $84 (1958% 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 1958% of the Medicare baseline (a markup of 1858%). 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
Blue Cross Blue Shield $3 - $96 70%
Tricare $3 70%
Caresource Mcr Adv-All Other Plans $4 93%
Humana $4 93%
Molina Marketplace - All Other Plans $4 93%
Molina Mcr Adv $4 93%
Signature Mcr Adv-All Plans $4 93%
Wellcare Mcr Adv-All Other Plans $4 93%
Passport Hp Hmo - All Plans $5 - $38 117%
Multiplan-All Plans $14 - $118 326%
Prime Health Services-All Plans $14 - $118 326%
Corvel - All Plans $15 - $125 350%
Integrated Hp-All Plans $15 - $124 350%
Center Care-All Plans $16 - $132 373%
Cigna $16 - $135 373%
Caresource Mcaid $17 - $139 396%
Coventry Mcaid-All Plans $17 - $139 396%
Medicaid / KanCare $17 - $139 396%
Molina Mcaid $17 - $139 396%
UnitedHealthcare $17 - $139 396%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 145 Newcomb Avenue, Mount Vernon, KY 40456
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals