CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: Fort Memorial Hospital

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85610
  • Insurance Median: $5
  • Cash Discount Price: $16
  • vs. Medicare Baseline: 1.17x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at Fort Memorial Hospital is $5. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $16. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 1.17x the Medicare baseline. Located in 611 Sherman Ave E, Fort Atkinson, WI.
Cash / Self-Pay
$16

Average discount available for prompt cash payment at this facility.

Insurance Median
$5

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: $16 (373%)
Insurance Median: $5 (117%)
Cash: $16 (373% of Medicare)
Ins. Median: $5 (117% 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
Blue Cross Blue Shield $2 - $5 47%
Dean Health Plan $2 - $35 47%
Managed Health Services $2 47%
Medicaid / KanCare $2 47%
Quartz $2 - $24 47%
UnitedHealthcare $2 - $7 47%
Molina $3 70%
Humana $4 93%
Centivo $5 117%
Veteran Evaluation Services $5 117%
Aetna $20 - $37 466%
Group Health Cooperative $32 - $249 746%
Alliance $36 839%
Mercycare $37 862%
Trilogy $44 1026%
Cigna $47 1096%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 611 Sherman Ave E, Fort Atkinson, WI 53538
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals