CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: UW Health

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85610
  • Insurance Median: $8
  • Cash Discount Price: $19
  • vs. Medicare Baseline: 1.86x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at UW Health is $8. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $19. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 1.86x the Medicare baseline. Located in 1401 East State Street, Rockford, IL.
Cash / Self-Pay
$19

Average discount available for prompt cash payment at this facility.

Insurance Median
$8

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: $19 (443%)
Insurance Median: $8 (186%)
Cash: $19 (443% of Medicare)
Ins. Median: $8 (186% 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.

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 $2 - $56 47%
Blue Cross Blue Shield $2 - $38 47%
Humana $2 - $4 47%
Medicare (plans) $2 - $5 47%
Mychoice Wi Medical Adv $2 - $4 47%
UnitedHealthcare $2 - $6 47%
Quartz Fully Insured $5 - $27 117%
Quartz Aso $6 - $42 140%
Ecoh $8 - $61 186%
Hfn $8 - $61 186%
Alliance Premier Network $40 - $42 932%
The Alliance $51 - $55 1189%
Wps Ppo $56 - $60 1305%
Cigna $58 - $62 1352%
Beloit Healt System $66 - $70 1538%
Mercycare $68 - $73 1585%
First Health/Coventry $71 - $76 1655%
Health Payment Systems $85 - $91 1981%
Healthsmart $85 - $91 1981%
Sheboygan Employers Health Network $90 - $97 2098%
Multiplan $101 - $108 2354%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1401 East State Street, Rockford, IL 61104
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals