CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: Marshfield Medical Center

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85610
Insurance Median: $48
Cash Discount Price: $53
vs. Medicare Baseline: 11.19x Medicare

The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at Marshfield Medical Center is $48. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $53. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 11.19x the Medicare baseline. Located in 611 St Joseph Ave, Marshfield, WI.

Cash / Self-Pay

$53

Average discount available for prompt cash payment at this facility.

Insurance Median

$48

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: $53 (1235%)

Insurance Median: $48 (1119%)

Cash: $53 (1235% of Medicare)

Ins. Median: $48 (1119% 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 1119% of the Medicare baseline (a markup of 1019%). 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	$4 - $27	93%
Security Health Plan (Shp)	$4 - $30	93%
Veteran'S Administration (Va Ccn)	$4	93%
Group Health Cooperative Of Eau Claire	$5 - $52	117%
Managed Health Services	$5	117%
UnitedHealthcare	$15	350%
Family Health Center (Fhc)	$28	653%
Amish/Mennonite	$31	723%
Sanford Health Plan	$31	723%
The Alliance	$39 - $47	909%
Besse Forest Products	$48	1119%
Molina Healthcare Of Wi	$48	1119%
Rice Lake School District	$48	1119%
Wps Health Insurance	$49 - $54	1142%
Trilogy	$50 - $54	1166%
Medica Of Wi	$52 - $53	1212%
Cigna	$53	1235%
Corvel	$53	1235%
First Health	$53	1235%
Health Partners	$53	1235%
Healtheos By Multiplan Inc.	$53	1235%
Three Rivers Provider Network (Trpn)	$53	1235%
Coventry	$54	1259%
Health Smart	$54	1259%
Rising Medical Work Comp	$54	1259%

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 $53.
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 Marshfield Medical Center 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.