CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: Mercy Hospital Oklahoma City, Inc

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85610
  • Insurance Median: $13
  • Cash Discount Price: $25
  • vs. Medicare Baseline: 3.03x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at Mercy Hospital Oklahoma City, Inc is $13. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $25. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 3.03x the Medicare baseline. Located in 4300 West Memorial Road, Oklahoma City, OK.
Cash / Self-Pay
$25

Average discount available for prompt cash payment at this facility.

Insurance Median
$13

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: $25 (583%)
Insurance Median: $13 (303%)
Cash: $25 (583% of Medicare)
Ins. Median: $13 (303% 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 303% of the Medicare baseline (a markup of 203%). 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 $3 - $40 70%
Amg Spec Hosp Edmond [20034] $4 93%
Blue Cross Blue Shield $4 93%
Champva [20065] $4 93%
Cherokee Nation Health Serv Contracted [320066] $4 93%
Cigna $4 - $6 93%
Cross Timbers Hospice [20098] $4 93%
Dept Of Veteran Affairs Contracted [320106] $4 93%
Elara Caring Aspire Hospice Contracted [320433] $4 93%
Elara Caring Aspire Hospice [20433] $4 93%
Globalhealth Contracted [320145] $4 93%
Halo Hcr Inc Hospice Contracted [320432] $4 93%
Halo Hcr Inc Hospice [20432] $4 93%
Humana $4 - $39 93%
Indian Health Service Contracted [320198] $4 93%
Kindful Hospice Contracted [320434] $4 93%
Kindful Hospice [20434] $4 93%
Longevity Health Plan [10477] $4 93%
Medicaid / KanCare $4 - $6 93%
Medicare (plans) $4 93%
Mercy Hospice Okc [20252] $4 93%
Mercy Rehab Hospital Contracted [320260] $4 93%
Provider Partners Health Plans Contracted [320450] $4 93%
Qual Choice Contracted [320325] $4 93%
Tricare $4 93%
United Medical Resources Contracted [320454] $4 - $36 93%
UnitedHealthcare $4 93%
Health Choice Contracted [320166] $5 117%
Medica Contracted [320239] $5 117%
Ambetter / Centene $6 140%
Community Care Contracted [320080] $6 - $39 140%
Home State Health Plan Contracted [320187] $6 140%
Novasys Contracted [320285] $6 140%
Workers Comp [20426] $7 163%
Healthcare Highways Plus Contracted [320175] $9 - $34 210%
Healthsmart Preferred Care Contracted [320184] $9 - $36 210%
Kempton Contracted [320214] $9 210%
Webtpa Contracted [320417] $9 - $24 210%
Osma Health Contracted [320292] $10 - $25 233%
Aither Health Contracted [320449] $13 - $34 303%
Auxiant Contracted [320462] $13 - $36 303%
Benefit Management Contracted [320052] $13 - $36 303%
Ebms Contracted [320493] $13 - $34 303%
Healthlink Contracted [320179] $13 - $36 303%
Imagine 360 Contracted [320494] $13 - $34 303%
Mercy Benefit Admin Contracted [320251] $13 - $36 303%
Quik Trip Contracted [320447] $13 - $34 303%
Reflect Health Contracted [320492] $13 - $34 303%
Show-Me Health Administrators Contracted [320483] $13 - $34 303%
Yuzu Health Contracted [320521] $13 - $34 303%
Federal Medical Center Contracted [320127] $14 - $36 326%
First Health Contracted [320128] $14 - $34 326%
Healthscope Contracted [320182] $14 - $36 326%
Healthsmart Accel Contracted [320183] $14 - $36 326%
Point C Contracted [320238] $14 - $36 326%
Preferred Health Plan Contracted [320522] $14 - $36 326%
Private Health Care Systems Contracted [320320] $14 - $39 326%
Tri State Healthcare Coalition Contracted [320379] $14 - $36 326%
Multiplan Contracted [320270] $15 - $50 350%
Globalhealth Contracted [320144] $16 - $40 373%
Preferred Community Choice Contracted [320311] $17 - $43 396%
Centralink Contracted [320480] $22 - $56 513%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 4300 West Memorial Road, Oklahoma City, OK 73120
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals