CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: Merit Health River Oaks

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85610
  • Insurance Median: $4
  • Cash Discount Price: $105
  • vs. Medicare Baseline: 0.93x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at Merit Health River Oaks is $4. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $105. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 0.93x the Medicare baseline. Located in 1030 River Oaks Drive, Flowood, MS.
Cash / Self-Pay
$105

Average discount available for prompt cash payment at this facility.

Insurance Median
$4

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: $105 (2448%)
Insurance Median: $4 (93%)
Cash: $105 (2448% of Medicare)
Ins. Median: $4 (93% 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
First Choice Coventry $1 - $304 23%
First Choice Mpcn Standard $1 - $321 23%
First Choice Ppo Plus $1 - $321 23%
First Choice Standard $1 - $269 23%
Phcs $1 - $350 23%
Self Pay $1 - $128 23%
UnitedHealthcare $1 - $156 23%
Advanced Health Systems $2 - $8 47%
Aetna $2 - $409 47%
American Health Group $2 - $496 47%
Beech Street $2 - $496 47%
Benefit Administration Services $2 - $496 47%
Benefit Management Systems $2 - $496 47%
Blue Cross Blue Shield $2 - $8 47%
Citizens State Bank Inc $2 - $496 47%
First Choice Stratose $2 - $467 47%
Formost $2 - $496 47%
Humana $2 - $4 47%
Medicaid / KanCare $2 - $4 47%
Medicare (plans) $2 - $4 47%
Molina $2 - $4 47%
Molina Exchange $2 - $8 47%
Ms Dept Of Rehabilitation Services $2 - $584 47%
Ms State Hospital Of Whitfield Ms $2 - $222 47%
Node Champva $2 - $4 47%
Node Devoted Health Mcr Adv $2 - $4 47%
Node First Choice American Health Mcr Adv $2 - $4 47%
Node First Choice Seven Corners $2 - $7 47%
Node First Choice Shared Health Of Ms Mcr Adv $2 - $4 47%
Node First Choice Wellcare Mcr Adv $2 - $4 47%
Node Hospice Non Par Agree $2 - $4 47%
Node Va $2 - $4 47%
Node Vantage Health Mcr Adv $2 - $4 47%
One Health Plan $2 - $526 47%
Prime Health Services $2 - $467 47%
Tricare $2 - $4 47%
Trimed Billing Solutions $2 - $175 47%
Usa Mco $2 - $496 47%
Veterans Eval Services $2 - $4 47%
Node Healthy Mississippi Mcr Adv $3 - $5 70%
Node Us Dept Of Labor $3 - $5 70%
Caresource Truecare $4 93%
First Choice Preferred $4 - $6 93%
Magnolia Exchange $4 - $8 93%
Magnolia Mcd Chip $4 93%
Molina Chip $4 93%
Node First Choice Occunet $4 - $6 93%
First Choice Lgp $5 - $9 117%
Vantage Health Commercial $5 - $10 117%
Ms Work Comp $7 163%
Prime Health Wc $7 163%
Cigna $116 2704%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1030 River Oaks Drive, Flowood, MS 39232
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals