Blood test, clotting time (PT/INR)
Facility: Rehabilitation Hospital of Wisconsin
Billing Code: 85610 (CPT)
- CPT Billing Code: 85610
- Insurance Median: $60
- Cash Discount Price: $64
- vs. Medicare Baseline: 13.99x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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 1399% of the Medicare baseline (a markup of 1299%). 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Alliance PPO | $17 - $54 | 396% |
| UnitedHealthcare | $17 - $78 | 396% |
| Trilogy PPO | $17 - $78 | 396% |
| Medica (Under Dean) | $17 - $54 | 396% |
| Dean PPO Hmo/Pos | $17 - $54 | 396% |
| Wps "Insurance" PPO | $17 - $57 | 396% |
| Hps Solutions PPO | $18 - $59 | 420% |
| PHCS Savility | $18 - $58 | 420% |
| Health Eos Poc | $19 - $62 | 443% |
| Aetna | $19 - $78 | 443% |
| Health Eos Multiplan | $20 - $66 | 466% |
| Coventry/First Health PPO | $20 - $64 | 466% |
| Hps (Other) | $20 - $64 | 466% |
| PHCS / Multiplan | $22 - $71 | 513% |
| Security Health Plan - Advocare | $24 - $78 | 559% |
| Blue Cross Blue Shield | $24 - $78 | 559% |
| VA - Primary Only - Authorization Required | $24 - $78 | 559% |
| Cigna | $24 - $78 | 559% |
| Unity Health Plan and Unity Quartz(Hmo/Pos) | $24 - $78 | 559% |
| Managed Health Services (Mhs) | $24 - $78 | 559% |
| Children's Communty Health Plan(Cchp) | $24 - $78 | 559% |
| Centivo Broad | $24 - $78 | 559% |
| Icare McD | $24 - $78 | 559% |
| All Savers | $24 - $78 | 559% |
| Humana | $24 - $78 | 559% |
| Wellcare McR | $24 - $78 | 559% |
| Network Health - Commercial | $24 - $78 | 559% |
| Medicaid / KanCare | $24 - $78 | 559% |
| Community Care, Inc | $24 - $78 | 559% |
| Molina (Fka Care Wisconsin) | $24 - $78 | 559% |
| Together With Cchp | $24 - $78 | 559% |
| Quartz (Self Funded) / Unity Health Plan (Hmo/Pos) | $24 - $78 | 559% |
| Medicare (plans) | $24 - $78 | 559% |
| Centivo Intermediate/Median | $24 - $78 | 559% |
| Network Health - Aca | $24 - $78 | 559% |
| Centivo Narrow/Value | $24 - $78 | 559% |