CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: Barnes-Jewish St Peters Hospital

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85610
Insurance Median: $19
Cash Discount Price: $17
vs. Medicare Baseline: 4.43x Medicare

The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at Barnes-Jewish St Peters Hospital is $19. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $17. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 4.43x the Medicare baseline. Located in 10 Hospital Dr, Saint Peters, MO.

Cash / Self-Pay

$17

Average discount available for prompt cash payment at this facility.

Insurance Median

$19

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: $17 (396%)

Insurance Median: $19 (443%)

Cash: $17 (396% of Medicare)

Ins. Median: $19 (443% 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 443% of the Medicare baseline (a markup of 343%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
UnitedHealthcare	$4 - $22	93%
Healthscope Benefits [258]	$5	117%
Sarah Bush Lincoln [636]	$5 - $7	117%
Cigna	$6 - $9	140%
Aetna	$7 - $22	163%
Allied Benefits [498]	$7 - $22	163%
Consociate [478]	$7	163%
Coresource [497]	$7	163%
Fmh Benefit Service Inc [222]	$7	163%
Mail Handlers [495]	$7	163%
Apwu Health Plan [216]	$9	210%
Nalc Health Benefit Plan [242]	$9	210%
Priority Health [648]	$9	210%
Blue Cross Blue Shield	$10 - $25	233%
Humana	$11	256%
Healthlink [225]	$14 - $22	326%
Cox Health Systems Insurance Company [220]	$16 - $19	373%
Health Alliance [224]	$16	373%
Hope Trust [806]	$17	396%
Med-Pay [480]	$19 - $22	443%
Unicare [568]	$19 - $22	443%
Beechstreet [551]	$22	513%
Detego Health [868]	$22	513%
First Health Commercial [734]	$22	513%
Health Systems Inc [620]	$22	513%
Healthcare Sol Mercy [609]	$22	513%
Multiplan Commercial [737]	$22	513%
Multiplan [240]	$22	513%
Phcs [244]	$22 - $23	513%
Preferred Health Professionals [561]	$22	513%
Hfn [563]	$23	536%
Medica [661]	$23	536%
Mh Magellan Health Services [270]	$29	676%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $17.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 85610.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Barnes-Jewish St Peters Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 85610.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.