CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: Montefiore Mount Vernon Hospital

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85610
  • Insurance Median: $5
  • Cash Discount Price: $11
  • vs. Medicare Baseline: 1.17x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at Montefiore Mount Vernon Hospital is $5. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $11. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 1.17x the Medicare baseline. Located in 12 North 7Th Avenue, Mount Vernon, NY.
Cash / Self-Pay
$11

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: $11 (256%)
Insurance Median: $5 (117%)
Cash: $11 (256% 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
Wellcare $3 - $4 70%
Amidacare $4 93%
Blue Cross Blue Shield $4 - $14 93%
Centerlight $4 93%
Emblem $4 - $14 93%
Fidelis $4 - $7 93%
Healthfirst $4 - $6 93%
Humana $4 93%
Longevity $4 93%
Medicaid / KanCare $4 93%
Point Comfort $4 93%
UnitedHealthcare $4 - $9 93%
Villagecaremax $4 93%
Vnsny Choice $4 - $5 93%
Metroplus $5 117%
Vnsny Select Health $5 117%
Oscar $6 140%
Mvp $8 186%
American Postal Workers $9 210%
Centivo $11 256%
Elderplan $14 326%
Aetna $19 - $21 443%
Cigna $38 - $43 886%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 12 North 7Th Avenue, Mount Vernon, NY 10550
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals