CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: Uofl Health - Shelbyville Hospital

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85610
Insurance Median: $12
Cash Discount Price: $27
vs. Medicare Baseline: 2.80x Medicare

The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at Uofl Health - Shelbyville Hospital is $12. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $27. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 2.80x the Medicare baseline. Located in 727 Hospital Drive, Shelbyville, KY.

Cash / Self-Pay

$27

Average discount available for prompt cash payment at this facility.

Insurance Median

$12

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: $27 (629%)

Insurance Median: $12 (280%)

Cash: $27 (629% of Medicare)

Ins. Median: $12 (280% 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 280% of the Medicare baseline (a markup of 180%). 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	$3 - $31	70%
Aetna	$4 - $12	93%
Communicare	$4	93%
Devoted	$4	93%
Essence Health	$4	93%
Humana	$4 - $12	93%
Passport	$4 - $36	93%
Senior Care Communty Of Ky	$4	93%
Signature	$4 - $36	93%
UnitedHealthcare	$4 - $34	93%
Va Ccn	$4	93%
Wellcare	$4 - $11	93%
Velocity	$5 - $70	117%
Key Benefit Administrators	$6	140%
Cigna	$7	163%
Prime Group Health	$25 - $60	583%
Encore	$43	1002%
Multiplan	$47 - $64	1096%
Omca	$67	1562%
Corvel	$71	1655%
Cshn	$71	1655%
Health Smart	$71	1655%
National Comp Care	$71	1655%

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 $27.
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 Uofl Health - Shelbyville Hospital 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.