CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: Warner Hospital and Health Services

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85610
Insurance Median: $45
Cash Discount Price: $82
vs. Medicare Baseline: 10.49x Medicare

The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at Warner Hospital and Health Services is $45. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $82. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 10.49x the Medicare baseline. Located in 422 W White St, Clinton, IL.

Cash / Self-Pay

$82

Average discount available for prompt cash payment at this facility.

Insurance Median

$45

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: $82 (1911%)

Insurance Median: $45 (1049%)

Cash: $82 (1911% of Medicare)

Ins. Median: $45 (1049% 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 1049% of the Medicare baseline (a markup of 949%). 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
Blue Cross Blue Shield	$13 - $120	303%
Aetna	$14 - $104	326%
Harmony Hp Mcaid-All Plans	$14	326%
Health Alliance Med Adv	$14 - $50	326%
Humana	$14 - $104	326%
Medicaid / KanCare	$14	326%
Meridian Hp-All Plans	$14	326%
Molina Mcr/Mcd Dual	$14 - $50	326%
Molina-All Other Plans	$14	326%
UnitedHealthcare	$14 - $104	326%
Wellcare Mcr Adv-All Plans	$14 - $50	326%
City Of Clinton (Employees Serv)-All Plans	$26 - $98	606%
Healthlink Hmo	$26 - $96	606%
Cigna	$27 - $102	629%
Caterpillar-All Plans	$28 - $104	653%
Multiplan Phcs-All Plans	$28 - $104	653%
Health Alliance-All Other Plans	$29 - $108	676%
Healthlink Ppo/Work Comp-All Other Plans	$29 - $108	676%
Consociate Care Ppo-All Plans	$30 - $111	699%
Hfn Ppo/Epo-All Plans	$30 - $111	699%
Three Rivers-All Plans	$31 - $117	723%

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 $82.
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 Warner Hospital and Health Services 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.