CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: Mercy Hospital - Cassville

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85610
  • Insurance Median: $66
  • Cash Discount Price: $53
  • vs. Medicare Baseline: 15.38x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at Mercy Hospital - Cassville is $66. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $53. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 15.38x the Medicare baseline. Located in 94 Main Street, Cassville, MO.
Cash / Self-Pay
$53

Average discount available for prompt cash payment at this facility.

Insurance Median
$66

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: $53 (1235%)
Insurance Median: $66 (1538%)
Cash: $53 (1235% of Medicare)
Ins. Median: $66 (1538% 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 1538% of the Medicare baseline (a markup of 1438%). 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
Aetna $4 - $73 93%
Blue Cross Blue Shield $4 - $80 93%
Humana $4 - $70 93%
Medicaid / KanCare $4 - $43 93%
Medicare (plans) $4 - $35 93%
UnitedHealthcare $6 - $78 140%
Dept Of Veteran Affairs Contracted [320106] $28 653%
Tricare $33 769%
Cherokee Nation Health Serv Contracted [320066] $34 793%
Cigna $34 - $78 793%
Cross Timbers Hospice [20098] $34 793%
Elara Caring Aspire Hospice [20433] $34 793%
Globalhealth Contracted [320145] $34 793%
Halo Hcr Inc Hospice Contracted [320432] $34 793%
Halo Hcr Inc Hospice [20432] $34 793%
Healthscope Contracted [320182] $34 793%
Indian Health Service Contracted [320198] $34 793%
Kindful Hospice Contracted [320434] $34 793%
Kindful Hospice [20434] $34 793%
Medical Associates Health Contracted [320444] $34 793%
Mercy Hospice Okc [20252] $34 793%
Mercy Mgd Behavioral Health Contracted [320259] $34 793%
Pace Of The Ozarks Contracted [320518] $34 793%
Provider Partners Health Plans Contracted [320450] $34 793%
Qual Choice Contracted [320325] $34 793%
Administrative Payor Contracted [320005] $37 862%
Centivo Contracted [320505] $42 979%
Ambetter / Centene $43 1002%
Home State Health Plan Contracted [320187] $43 1002%
Novasys Contracted [320285] $43 1002%
Healthlink Contracted [320179] $53 - $74 1235%
Preferred Health Plan Contracted [320522] $53 1235%
Health Systems Inc Contracted [320174] $66 1538%
Insurance System Inc Contracted [320465] $66 1538%
Municipal Health Plan Contracted [320271] $66 1538%
Point C Contracted [320238] $66 - $74 1538%
Point C [20238] $66 1538%
United Medical Resources Contracted [320454] $66 - $70 1538%
Workers Comp [20426] $66 - $74 1538%
Medica Contracted [320239] $73 1702%
90 Degree Benefits Contracted [320436] $74 1725%
Aither Health Contracted [320449] $74 1725%
American Healthcare Alliance Contracted [320020] $74 1725%
Auxiant Contracted [320462] $74 1725%
Benefit Management Contracted [320052] $74 1725%
Ebms Contracted [320493] $74 1725%
Edison Health Solutions Contracted [320502] $74 1725%
Evolutions Health Care Contracted [320124] $74 1725%
Imagine 360 Contracted [320494] $74 1725%
Mercy Benefit Admin Contracted [320251] $74 1725%
Reflect Health Contracted [320492] $74 1725%
Show-Me Health Administrators Contracted [320483] $74 1725%
Usa Managed Care Org Contracted [320429] $74 1725%
Yuzu Health Contracted [320521] $74 1725%
First Health Contracted [320128] $78 1818%
Multiplan Contracted [320270] $78 1818%
Private Health Care Systems Contracted [320320] $78 1818%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 94 Main Street, Cassville, MO 65625
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Critical Access Hospitals