CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: Merit Health Women's Hospital

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85610
  • Insurance Median: $7
  • Cash Discount Price: $101
  • vs. Medicare Baseline: 1.63x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at Merit Health Women's Hospital is $7. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $101. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 1.63x the Medicare baseline. Located in 1026 River Oaks Drive, Flowood, MS.
Cash / Self-Pay
$101

Average discount available for prompt cash payment at this facility.

Insurance Median
$7

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: $101 (2354%)
Insurance Median: $7 (163%)
Cash: $101 (2354% of Medicare)
Ins. Median: $7 (163% 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 - $314 93%
Caresource Truecare $4 93%
Humana $4 93%
Magnolia Mcd Ms Chip $4 93%
Medicaid / KanCare $4 93%
Medicare (plans) $4 93%
Molina Chip $4 93%
Node Champva $4 93%
Node Devoted Health Mcr Adv $4 93%
Node First Choice American Health Of Ms Mcr Adv $4 93%
Node First Choice Wellcare Mcr Adv $4 93%
Node Molina Mcr Adv $4 93%
Node Shared Health Of Ms Mcr Adv $4 93%
Node Va $4 93%
Node Vantage Health Mcr Adv $4 93%
Node Windsor Mcr Adv $4 93%
Tricare $4 93%
UnitedHealthcare $4 - $128 93%
Veterans Eval Services $4 93%
Node Healthy Mississippi Mcr Adv $5 117%
Node Us Dept Of Labor $5 117%
First Choice Preferred $6 140%
Occunet $6 140%
Node First Choice Seven Corners $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%
Cigna $98 2284%
Self Pay $99 2308%
Trimed Billing Solutions $134 3124%
State Hospital $170 3963%
First Choice Mpcn $202 4709%
First Choice Standard $206 4802%
Coventry First Health $233 5431%
First Choice Ppo Plus $246 5734%
Benefit Management Systems $323 - $381 7529%
First Choice Stratose $358 8345%
Health Choice Of Mississippi $358 8345%
Prime Health Services $358 8345%
Mississippi Department Of Rehabilitation Services $448 10443%
Ms Work Comp $448 10443%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1026 River Oaks Drive, Flowood, MS 39232
  • CMS Rating: No CMS Rating
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals