CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: St Catherine of Siena Hospital

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85610
  • Insurance Median: $4
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 0.93x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at St Catherine of Siena Hospital is $4. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 0.93x the Medicare baseline. Located in 50 Route 25A, Smithtown, NY.
Cash / Self-Pay
Unavailable

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%)
Insurance Median: $4 (93%)
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
Aetna $4 - $6 93%
Affinity Health Plan $4 - $9 93%
Agewell New York $4 93%
Beacon Health Options $4 - $145 93%
Beacon Health Strategies $4 - $6 93%
Blue Cross Blue Shield $4 - $14 93%
Centerlight Healthcare $4 93%
Centers Plan For Healthy Living $4 93%
Elderplan Inc. $4 93%
Emblem Health $4 - $10 93%
Fidelis Care New York $4 - $9 93%
Health First $4 - $10 93%
Health Plus $4 - $9 93%
Healthspring $4 93%
Humana $4 93%
Independent Health $4 93%
Liberty Health $4 93%
Longevity Health Plan $4 93%
Medicaid / KanCare $4 93%
Medicare (plans) $4 93%
Mvp Health Plans $4 - $11 93%
Orthonet - Uniformed Services Family Health Plan $4 93%
Partners Health Plan $4 93%
Pmc $4 93%
Senior Whole Health $4 93%
Surest $4 93%
Tricare $4 93%
UnitedHealthcare $4 - $14 93%
Universal Healthcare $4 93%
Us Family Health Plan $4 93%
Veterans Affairs $4 93%
Wellcare Health Plan Inc $5 117%
Centivo $6 - $11 140%
Mail Handlers Benefit Plan $6 140%
Meritain Health $6 140%
Nippon Life Insurance Company Of America $6 140%
Salvation Army $6 140%
Zadroga $6 140%
American Plan Administrators $10 233%
Amerihealth Administrators $10 233%
Benefit Services $10 233%
Ghi Cbp Ny City Employee Alternate $10 233%
International Benefit Administrator $10 233%
Ultra Benefits Inc. $10 233%
Apwu $11 256%
Brighton $11 - $86 256%
Cigna $11 - $80 256%
Daniel H Cook $11 256%
Nalc $11 256%
Samba $11 256%
Self Pay $14 326%
Local 1199 $24 559%
Oscar Health $50 1166%
Allied Wellfare Fund $80 1865%
American Group Administrators $80 1865%
Bakery & Confectionery Union $80 1865%
Comprehensive Benefits Consultant $80 1865%
Guardian Life Insurance Company Of America $80 1865%
Maloney And Assoc $80 1865%
Multiplan $80 1865%
Performax $80 1865%
Phcs $80 1865%
Pomco $80 1865%
Tpa Inc $80 1865%
Unicare $80 1865%
United Employees Health Plan $80 1865%
Coventry $91 - $98 2121%
Magellan $98 2284%
Galaxy $111 2587%
Three Rivers Provider Network $111 2587%
Aither Health $123 2867%
Alpha Care $123 2867%
Dentaquest $123 2867%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 50 Route 25A, Smithtown, NY 11787
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals