CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: St Joseph's University Medical Center Inc

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85610
  • Insurance Median: $8
  • Cash Discount Price: $68
  • vs. Medicare Baseline: 1.86x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at St Joseph's University Medical Center Inc is $8. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $68. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 1.86x the Medicare baseline. Located in 703 Main St, Paterson, NJ.
Cash / Self-Pay
$68

Average discount available for prompt cash payment at this facility.

Insurance Median
$8

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: $68 (1585%)
Insurance Median: $8 (186%)
Cash: $68 (1585% of Medicare)
Ins. Median: $8 (186% 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
UnitedHealthcare $3 - $9 70%
Wellpoint $3 - $4 70%
Aetna $4 - $14 93%
Amerihealth $4 - $43 93%
Blue Cross Blue Shield $4 - $59 93%
Clover Health $4 93%
Fidelis Care of New Jersey $4 - $14 93%
Horizon New Jersey Total Care $4 93%
Horizon New Jersey Health $5 117%
Longevity Health Plan $5 117%
Ambetter / Centene $6 140%
Consumer Health Network $6 - $61 140%
Oxford $9 210%
Private Healthcare Systems $44 1026%
Magnacare $48 1119%
Multiplan $51 1189%
Oscar $64 1492%
Cigna $68 1585%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 703 Main St, Paterson, NJ 07503
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals