CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: Merit Health Wesley

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85610
  • Insurance Median: $5
  • Cash Discount Price: $43
  • vs. Medicare Baseline: 1.17x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at Merit Health Wesley is $5. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $43. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 1.17x the Medicare baseline. Located in 5001 W Hardy St, Hattiesburg, MS.
Cash / Self-Pay
$43

Average discount available for prompt cash payment at this facility.

Insurance Median
$5

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: $43 (1002%)
Insurance Median: $5 (117%)
Cash: $43 (1002% of Medicare)
Ins. Median: $5 (117% 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
Medicaid / KanCare $3 - $4 70%
Aetna $4 - $71 93%
Caresource Truecare $4 93%
First Choice $4 - $136 93%
Humana $4 93%
Magnolia $4 93%
Magnolia Mcd Ms Chip $4 93%
Medicare (plans) $4 93%
Molina $4 93%
Molina Chip $4 93%
Node Champva $4 93%
Node Devoted Health Mcr Adv $4 93%
Node First Choice American Health Mcr Adv $4 93%
Node First Choice Wellcare Mcr Adv $4 93%
Node Hospice Non Par Agree $4 93%
Node Va $4 93%
Node Vantage Mcr Adv $4 93%
Tricare $4 93%
UnitedHealthcare $4 - $19 93%
Veterans Eval Services $4 93%
Node Healthy Mississippi Mcr Adv $5 117%
Node Us Dept Of Labor $5 117%
First Choice Molina $7 163%
Ms Work Comp $7 163%
Advanced Health Systems $8 186%
Blue Cross Blue Shield $8 186%
Magnolia Exchange $8 186%
Molina Exchange $8 186%
First Choice Lgp $9 210%
Vantage Health $10 233%
Chs Group Health Plan $34 793%
Self Pay $36 - $51 839%
Cigna $48 1119%
Trimed Billing Solutions $51 1189%
Benefit Management Services $110 2564%
Coventry First Health $127 2960%
Ms Dept Of Rehabilitation Services $170 3963%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 5001 W Hardy St, Hattiesburg, MS 39402
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals