CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: Uh St John Medical Center

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85610
  • Insurance Median: $46
  • Cash Discount Price: $69
  • vs. Medicare Baseline: 10.72x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at Uh St John Medical Center is $46. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $69. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 10.72x the Medicare baseline. Located in 29000 Center Ridge Road, Westlake, OH.
Cash / Self-Pay
$69

Average discount available for prompt cash payment at this facility.

Insurance Median
$46

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: $69 (1608%)
Insurance Median: $46 (1072%)
Cash: $69 (1608% of Medicare)
Ins. Median: $46 (1072% 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 1072% of the Medicare baseline (a markup of 972%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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 - $10 93%
Blue Cross Blue Shield $4 - $52 93%
Cigna $4 - $52 93%
Devoted Health $4 93%
Humana $4 93%
Molina $4 93%
Paramount $4 93%
Perennial Advantage Of Ohio $4 93%
Primetime Health Plan $4 93%
Summacare $4 - $47 93%
The Health Plan $4 - $61 93%
UnitedHealthcare $4 - $60 93%
Valor Health Plans $4 93%
Wellcare By Allwell $4 93%
University Health Employee Plan (Contigo) $5 117%
Ambetter / Centene $8 186%
Caresource $8 186%
Medical Mutual Of Ohio $25 - $39 583%
Amish Aid Community Plan $42 979%
Amish Church Fund And Workers Aid Plan $42 979%
Buckeye Plain Ministries $42 979%
Jp Farley $43 1002%
Clarity $44 1026%
Christian Healthcare Ministries $46 1072%
Immergrun $46 1072%
Sunrise Plan Communities $46 1072%
Aultcare $51 1189%
Healthsmart $60 1399%
Ohio Health Choice $60 - $83 1399%
Medical Mutual Traditional/Health Ohio $64 1492%
Beech Street $74 - $83 1725%
Ohio Preferred Network $74 - $83 1725%
First Health $76 1772%
Century Health Network $78 1818%
Private Healthcare System $79 1841%
Configurenet $83 1935%
Fortified Provider Network $83 1935%
Multiplan $83 1935%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 29000 Center Ridge Road, Westlake, OH 44145
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals