CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: Shands Jacksonville

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85610
  • Insurance Median: $62
  • Cash Discount Price: $78
  • vs. Medicare Baseline: 14.45x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at Shands Jacksonville is $62. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $78. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 14.45x the Medicare baseline. Located in 655 W 8Th St, Jacksonville, FL.
Cash / Self-Pay
$78

Average discount available for prompt cash payment at this facility.

Insurance Median
$62

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: $78 (1818%)
Insurance Median: $62 (1445%)
Cash: $78 (1818% of Medicare)
Ins. Median: $62 (1445% 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 1445% of the Medicare baseline (a markup of 1345%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Aetna $2 - $117 47%
Carelon Health $2 47%
Humana $2 - $121 47%
Amerihealth Caritas Florida $3 70%
Community Care Plan $3 70%
Florida Community Care $3 70%
Molina $3 - $6 70%
Simply Healthcare $3 70%
Ameri-Plus Preferred Care $4 93%
Avmed $4 - $80 93%
Beacon Health Strategies $4 93%
Blue Cross Blue Shield $4 - $971 93%
Capital Health Plan $4 - $71 93%
Careplus Health Plan $4 93%
Devoted Health Plan $4 - $5 93%
Florida Health Care Plan $4 - $8 93%
UnitedHealthcare $4 - $407 93%
Volusia Health Network $4 - $60 93%
Florida Complete Care $5 117%
North Florida Evaluation & Treatment Center $5 - $67 117%
Northeast Florida State Hospital $5 - $62 117%
Positive Healthcare Partners $5 117%
Wellcare Of Florida $5 117%
Centivo $6 - $78 140%
Disney Cruise Line $6 - $85 140%
Ambetter / Centene $7 163%
Cigna $7 - $88 163%
Health First Health Plan $7 - $106 163%
Mental Health Associates $7 - $92 163%
Prime Health Services $7 - $106 163%
Wellpath $7 163%
Archbold Medical Center $8 - $106 186%
Florida Health Alliance $8 - $102 186%
Genex $8 - $106 186%
Rockport Provider $8 - $106 186%
Corvel Corp $9 - $121 210%
First Health $9 - $121 210%
Florida Hospital Healthcare System $9 - $121 210%
Medsave Usa Tpa $9 - $121 210%
Fringe Benefits Coordinators $10 - $135 233%
Multiplan $10 - $128 233%
Novanet $10 - $128 233%
Truli For Health $375 8741%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 655 W 8Th St, Jacksonville, FL 32209
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals