CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: Mercy Hospital Southeast

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85610
  • Insurance Median: $8
  • Cash Discount Price: $72
  • vs. Medicare Baseline: 1.86x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at Mercy Hospital Southeast is $8. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $72. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 1.86x the Medicare baseline. Located in 1701 Lacey St, Cape Girardeau, MO.
Cash / Self-Pay
$72

Average discount available for prompt cash payment at this facility.

Insurance Median
$8

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: $72 (1678%)
Insurance Median: $8 (186%)
Cash: $72 (1678% of Medicare)
Ins. Median: $8 (186% 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
Aetna $4 - $79 93%
American Health Advantage Of Mo Mcr Hmo Contracted [320264] $4 93%
Blue Cross Blue Shield $4 - $118 93%
Cross Timbers Hospice [20098] $4 93%
Dept Of Veteran Affairs Contracted [320106] $4 93%
Elara Caring Aspire Hospice Contracted [320433] $4 93%
Elara Caring Aspire Hospice [20433] $4 93%
Halo Hcr Inc Hospice Contracted [320432] $4 93%
Halo Hcr Inc Hospice [20432] $4 93%
Humana $4 - $105 93%
Kindful Hospice Contracted [320434] $4 93%
Kindful Hospice [20434] $4 93%
Medicaid / KanCare $4 - $19 93%
Medicare (plans) $4 93%
Mercy Hospice Okc [20252] $4 93%
Pace Of The Ozarks Contracted [320518] $4 93%
Tricare $4 93%
UnitedHealthcare $4 - $10 93%
Provider Partners Health Plans Contracted [320450] $5 117%
United Medical Resources Contracted [320454] $5 117%
Ambetter / Centene $6 140%
Consociate Consolidated Health Contracted [320490] $6 - $9 140%
Home State Health Plan Contracted [320187] $6 140%
Auxiant Contracted [320462] $7 - $8 163%
Centivo Contracted [320505] $7 163%
Ebms Contracted [320493] $7 163%
Healthlink Contracted [320179] $7 - $97 163%
Imagine 360 Contracted [320494] $7 163%
Mercy Benefit Admin Contracted [320251] $7 - $84 163%
Reflect Health Contracted [320492] $7 163%
Yuzu Health Contracted [320521] $7 - $84 163%
Preferred Health Plan Contracted [320522] $8 186%
Hope Trust Contracted [320488] $11 256%
Cigna $12 280%
First Health Contracted [320128] $62 - $79 1445%
Health Alliance Contracted [320164] $63 - $81 1469%
Aither Health Contracted [320449] $66 - $84 1538%
Edison Health Solutions Contracted [320502] $66 - $84 1538%
Mercy Benefit Admin [20251] $66 - $84 1538%
Workers Comp [20426] $73 - $99 1702%
Multiplan Contracted [320270] $78 - $99 1818%
Private Health Care Systems Contracted [320320] $78 - $99 1818%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1701 Lacey St, Cape Girardeau, MO 63701
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals