CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: HCA Healthone Rose

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85610
Insurance Median: $154
Cash Discount Price: $749
vs. Medicare Baseline: 35.90x Medicare

The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at HCA Healthone Rose is $154. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $749. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 35.90x the Medicare baseline. Located in 4567 E 9Th Ave, Denver, CO.

Cash / Self-Pay

$749

Average discount available for prompt cash payment at this facility.

Insurance Median

$154

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: $749 (17459%)

Insurance Median: $154 (3590%)

Cash: $749 (17459% of Medicare)

Ins. Median: $154 (3590% 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 3590% of the Medicare baseline (a markup of 3490%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Cigna	$2 - $481	47%
Aetna	$4 - $397	93%
Blue Cross Blue Shield	$4 - $556	93%
Bright Health	$4 - $226	93%
Delaware Life Insurance	$4	93%
Devoted Health	$4	93%
Humana	$4	93%
Innovage Pace	$4	93%
Kaiser	$4 - $196	93%
Mutual Of Omaha	$4	93%
Rocky Mountain Health	$4	93%
Rocky Mountain Health Plan	$4	93%
Total Longterm Care	$4	93%
Triwest Health Alliance	$4	93%
United	$4 - $338	93%
Wellcare	$4	93%
Multiplan	$12 - $677	280%
Pinnacol Workers Comp	$12	280%
Vail Health	$113 - $114	2634%
Colorado Program For Children With Special Needs	$336 - $338	7832%
Western Plains Community Health	$485 - $489	11305%
Northcare	$522 - $526	12168%
Physician Health Partners	$522 - $526	12168%
Medical Development International	$597 - $602	13916%
Rocky Mtn Planned Parenthood	$634 - $639	14779%
Prime Health	$671 - $677	15641%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $749.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 85610.

Insurance In-Network Protection Plan

Contact your insurance company to confirm HCA Healthone Rose is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 85610.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.