CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: Mercy Hospital Lincoln

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85610
Insurance Median: $19
Cash Discount Price: $32
vs. Medicare Baseline: 4.43x Medicare

The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at Mercy Hospital Lincoln is $19. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $32. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 4.43x the Medicare baseline. Located in 1000 East Cherry Street, Troy, MO.

Cash / Self-Pay

$32

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: $32 (746%)

Insurance Median: $19 (443%)

Cash: $32 (746% 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
Medicaid / KanCare	$1 - $35	23%
Aetna	$3 - $50	70%
United Medical Resources Contracted [320454]	$4	93%
UnitedHealthcare	$4 - $18	93%
American Health Advantage Of Mo Mcr [10473]	$5 - $18	117%
Blue Cross Blue Shield	$5 - $37	117%
Cherokee Nation Health Serv Contracted [320066]	$5 - $18	117%
Cigna	$5 - $19	117%
Cross Timbers Hospice [20098]	$5 - $18	117%
Dept Of Veteran Affairs Contracted [320106]	$5 - $18	117%
Elara Caring Aspire Hospice Contracted [320433]	$5 - $18	117%
Elara Caring Aspire Hospice [20433]	$5 - $18	117%
Globalhealth Contracted [320145]	$5 - $18	117%
Halo Hcr Inc Hospice Contracted [320432]	$5 - $18	117%
Halo Hcr Inc Hospice [20432]	$5 - $18	117%
Humana	$5 - $69	117%
Indian Health Service Contracted [320198]	$5 - $18	117%
Kindful Hospice Contracted [320434]	$5 - $18	117%
Kindful Hospice [20434]	$5 - $18	117%
Medicare (plans)	$5 - $77	117%
Mercy Hospice Okc [20252]	$5 - $18	117%
Pace Of The Ozarks Contracted [320518]	$5 - $18	117%
Provider Partners Health Plans Contracted [320450]	$5 - $18	117%
Qual Choice Contracted [320325]	$5 - $18	117%
Tricare	$5 - $16	117%
Healthlink Contracted [320179]	$6 - $65	140%
Centivo Contracted [320505]	$8 - $28	186%
Medica Contracted [320239]	$9 - $32	210%
Ambetter / Centene	$10 - $35	233%
Home State Health Plan Contracted [320187]	$10 - $35	233%
Novasys Contracted [320285]	$10 - $35	233%
Hope Trust Contracted [320488]	$11 - $38	256%
Health Choices Contracted [320448]	$13 - $46	303%
Health Choices [20448]	$13 - $46	303%
Medical Associates Health Contracted [320444]	$13 - $46	303%
First Health Contracted [320128]	$14 - $58	326%
Mercy Mgd Behavioral Health Contracted [320259]	$16 - $58	373%
Multiplan Contracted [320270]	$16 - $58	373%
Private Health Care Systems Contracted [320320]	$16 - $58	373%
Workers Comp [20426]	$16 - $62	373%
Aither Health Contracted [320449]	$19 - $65	443%
Aither Health [20449]	$19 - $65	443%
Auxiant Contracted [320462]	$19 - $65	443%
Ebms Contracted [320493]	$19 - $65	443%
Edison Health Solutions Contracted [320502]	$19 - $65	443%
Federal Medical Center Contracted [320127]	$19 - $65	443%
Imagine 360 Contracted [320494]	$19 - $65	443%
Insurance System Inc Contracted [320465]	$19 - $65	443%
Mercy Benefit Admin Contracted [320251]	$19 - $65	443%
Mercy Benefit Admin [20251]	$19 - $65	443%
Point C Contracted [320238]	$19 - $65	443%
Preferred Health Plan Contracted [320522]	$19 - $65	443%
Reflect Health Contracted [320492]	$19 - $65	443%
Show-Me Health Administrators Contracted [320483]	$19 - $65	443%
Tri State Healthcare Coalition Contracted [320379]	$19 - $65	443%
Yuzu Health Contracted [320521]	$19 - $65	443%

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 $32.
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 Mercy Hospital Lincoln 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.