CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: Westfield Memorial Hospital Inc

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85610
  • Insurance Median: $4
  • Cash Discount Price: $23
  • vs. Medicare Baseline: 0.93x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at Westfield Memorial Hospital Inc is $4. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $23. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 0.93x the Medicare baseline. Located in 189 E Main St, Westfield, NY.
Cash / Self-Pay
$23

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: $23 (536%)
Insurance Median: $4 (93%)
Cash: $23 (536% 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
Univera $2 - $5 47%
Highmark $3 - $10 70%
Aetna $4 - $8 93%
American Health Plans $4 93%
Amerihealth $4 93%
Cigna $4 93%
Jefferson Health Plans $4 - $6 93%
Life Pittsburgh $4 93%
Martin'S Point $4 - $12 93%
Medicare (plans) $4 93%
UnitedHealthcare $4 - $6 93%
Humana $5 117%
Molina $5 117%
Geisinger $6 140%
Pennsylvania Health And Wellness $6 140%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 189 E Main St, Westfield, NY 14787
  • CMS Rating: No CMS Rating
  • Ownership Type: N/A
  • Hospital Type: PART A PROVIDER - RURAL EMERGENCY HOSPITAL (REH)