CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: Crossing Rivers Health Medical Center

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85610
Insurance Median: $87
Cash Discount Price: $91
vs. Medicare Baseline: 20.28x Medicare

The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at Crossing Rivers Health Medical Center is $87. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $91. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 20.28x the Medicare baseline. Located in 37868 Us Hwy 18, Prairie Du Chien, WI.

Cash / Self-Pay

$91

Average discount available for prompt cash payment at this facility.

Insurance Median

$87

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: $91 (2121%)

Insurance Median: $87 (2028%)

Cash: $91 (2121% of Medicare)

Ins. Median: $87 (2028% 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 2028% of the Medicare baseline (a markup of 1928%). 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
Amerigroup Mcaid-All Other Plans	$8	186%
Iowa Total Care Mcaid-All Plans	$8	186%
Amerigroup Mcr Adv	$38 - $39	886%
Blue Cross Blue Shield	$38 - $89	886%
Security Hlth Mcr Adv	$38 - $39	886%
UnitedHealthcare	$38 - $39	886%
Humana	$39 - $88	909%
Quartz - All Plans	$73 - $74	1702%
Dean Health Plan - All Plans	$86 - $87	2005%
Medica Comm - All Other Plans	$86 - $87	2005%
Medica Hp Solutions	$86 - $87	2005%
Security Hlth Comm - All Other Plans	$86 - $87	2005%
Health Trad Hp - All Plans	$87 - $88	2028%
Cigna	$88 - $89	2051%
Group Health Co-Op - All Plans	$88 - $89	2051%
Health Partners - All Plans	$88 - $89	2051%
Medical Associates Hp - All Plans	$88 - $89	2051%
Preferred Health Choice - All Plans	$88 - $89	2051%
Wea Provider Ntwrk - All Plans	$88	2051%
Wps - All Plans	$88 - $89	2051%
First Health - All Plans	$89	2075%
Geha - All Plans	$89	2075%

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 $91.
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 Crossing Rivers Health 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.