CMS Price Transparency Data
Blood test, clotting time (PT/INR)
Facility: Mount Carmel East & West
Billing Code: 85610 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 85610
- Insurance Median: $22
- Cash Discount Price: $85
- vs. Medicare Baseline: 5.13x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at Mount Carmel East & West is $22. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $85. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 5.13x the Medicare baseline. Located in 6001 East Broad Street, Columbus, OH.
Cash / Self-Pay
$85
Average discount available for prompt cash payment at this facility.
Insurance Median
$22
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: $85 (1981%)
Insurance Median: $22 (513%)
Cash: $85 (1981% of Medicare)
Ins. Median: $22 (513% 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 513% of the Medicare baseline (a markup of 413%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
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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 - $48 | 93% |
| Blue Benefit Administrators Of Massachusetts | $4 | 93% |
| Blue Care Network | $4 | 93% |
| Blue Cross Blue Shield | $4 - $123 | 93% |
| Blue Distinction Transplant | $4 | 93% |
| Blue Shield - Ca | $4 | 93% |
| Blue Shield - Id (Regence) | $4 | 93% |
| Blue Shield - Ny Highmark Northeastern | $4 | 93% |
| Blue Shield - Ny Highmark Western | $4 | 93% |
| Blue Shield - Pa (Highmark) | $4 | 93% |
| Blue Shield - Wa (Regence) | $4 | 93% |
| Hospice Mount Carmel | $4 | 93% |
| Medicare (plans) | $4 - $132 | 93% |
| Oscar | $4 | 93% |
| Rural Carrier Health Benefit Plan | $4 | 93% |
| The Health Plan | $4 - $128 | 93% |
| UnitedHealthcare | $4 - $126 | 93% |
| Enterprise Group Planning | $8 | 186% |
| Medical Mutual | $8 - $37 | 186% |
| Custom Design Benefits | $9 | 210% |
| Quality Care Partners | $10 | 233% |
| Western & Southern Financial Group | $11 | 256% |
| American Postal Workers Secondary | $17 | 396% |
| Cigna | $17 | 396% |
| Health Partners | $17 | 396% |
| Healthgram | $17 | 396% |
| Mvp | $17 | 396% |
| Priority Health | $17 | 396% |
| Access Health | $22 | 513% |
| Acclaim | $22 | 513% |
| Administrative Concepts | $22 | 513% |
| Allegeant | $22 | 513% |
| Allied Benefit Systems | $22 | 513% |
| American Family | $22 | 513% |
| American Healthcare Alliance | $22 | 513% |
| American National | $22 | 513% |
| American Republic | $22 | 513% |
| Amerihealth | $22 | 513% |
| Aultcare | $22 | 513% |
| Automated Benefit Services | $22 | 513% |
| Auxiant | $22 | 513% |
| Benefit Administrative Systems,Llc | $22 | 513% |
| Boon Chapman | $22 | 513% |
| Cam Administrative Services | $22 | 513% |
| Christian Brother Services | $22 | 513% |
| Christian Brothers Holy Cross | $22 | 513% |
| Claimchoice Adminstrators | $22 | 513% |
| Comprehensive Benefits | $22 | 513% |
| Continental Life Insurance | $22 | 513% |
| Coventry | $22 | 513% |
| Custom Benefit Administrators | $22 | 513% |
| Cypress Benefit Administrators | $22 | 513% |
| Employee Benefit Concepts | $22 | 513% |
| Employee Benefit Management | $22 | 513% |
| Forest County Potawatomi | $22 | 513% |
| Freedom Life Insurance Company | $22 | 513% |
| Geha | $22 - $69 | 513% |
| Gravie Admin Services | $22 | 513% |
| Group Administrators | $22 | 513% |
| Group Marketing Services | $22 | 513% |
| Group Pension Administrators | $22 | 513% |
| Guardian | $22 | 513% |
| Health America | $22 | 513% |
| Health Choices | $22 | 513% |
| Healthcare Management Admin | $22 | 513% |
| Healthez | $22 | 513% |
| Insight | $22 | 513% |
| Intercare | $22 | 513% |
| Jfp Benefit Management | $22 | 513% |
| Jp Farley Corporation | $22 | 513% |
| Key Benefit Administrator | $22 | 513% |
| Liberty Union Life Assurance Co | $22 | 513% |
| Lucent Health | $22 | 513% |
| Luminare Health | $22 | 513% |
| Magnacare | $22 | 513% |
| Medcost | $22 | 513% |
| Meritain | $22 | 513% |
| Mutual Health Services | $22 | 513% |
| Mutual Of Omaha | $22 | 513% |
| Ncas | $22 | 513% |
| Nippon Life Ins | $22 | 513% |
| Nova | $22 | 513% |
| Painters Union Insurance Fund | $22 | 513% |
| Physicians Mutual | $22 | 513% |
| Plumbers Local 98 Insurance Fund | $22 | 513% |
| Prairie States | $22 | 513% |
| Preferred One | $22 | 513% |
| Primary Physician Care | $22 | 513% |
| Professional Benefit Administrators | $22 | 513% |
| Secureone Preferred United Plans | $22 | 513% |
| Siho Insurance Services | $22 | 513% |
| Sisco Benefits | $22 | 513% |
| The Loomis Company | $22 | 513% |
| Trustmark Small Business Benefits | $22 | 513% |
| U Of M Health Plan | $22 | 513% |
| Unicare | $22 | 513% |
| Unified Group Services | $22 | 513% |
| Us Health And Life | $22 | 513% |
| Valenz | $22 | 513% |
| Varipro | $22 | 513% |
| Webtpa | $22 | 513% |
| Wps | $22 | 513% |
| First Health | $25 | 583% |
| Humana | $25 - $48 | 583% |
| Consociate | $29 | 676% |
| Health Ohio Network | $29 | 676% |
| Medben | $29 - $36 | 676% |
| Caresource | $35 | 816% |
| Healthlink Inc | $36 | 839% |
| Medical Benefits Mutual | $36 | 839% |
| Ohio Health Choice | $36 | 839% |
| Ohio Ppo Connect | $36 | 839% |
| Ameriben | $38 | 886% |
| Luminare Health (Detroit) | $38 | 886% |
| Medi Share | $38 | 886% |
| Multiplan | $38 | 886% |
| Ohiohealthy | $38 | 886% |
| Osu Not Independent Choice | $38 | 886% |
| Phcs | $38 | 886% |
| Philadelphia American Life Insurance | $38 | 886% |
| Twin Valley Psychiatric | $38 | 886% |
| Health Smart | $41 | 956% |
| Bccp | $48 | 1119% |
| Medicaid / KanCare | $48 | 1119% |
| Optima Health | $48 | 1119% |
| Crime Victim Assistance | $632 | 14732% |
| Ohio Safe Program | $632 | 14732% |