CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: HCA Florida Highlands Hospital

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85610
  • Insurance Median: $7
  • Cash Discount Price: $240
  • vs. Medicare Baseline: 1.63x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at HCA Florida Highlands Hospital is $7. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $240. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 1.63x the Medicare baseline. Located in 3600 S Highlands Ave, Sebring, FL.
Cash / Self-Pay
$240

Average discount available for prompt cash payment at this facility.

Insurance Median
$7

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: $240 (5594%)
Insurance Median: $7 (163%)
Cash: $240 (5594% of Medicare)
Ins. Median: $7 (163% 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
Aetna $4 - $72 93%
Blue Cross Blue Shield $4 93%
Devoted Health $4 93%
Humana $4 - $96 93%
Ndms Definitive Care $4 93%
Prominence Healthfirst $4 93%
Sunshine State $4 - $5 93%
United $4 - $108 93%
Wellmed $4 93%
American Health Plan $5 117%
Amerihealth Caritas $5 117%
Centurion $5 117%
Cigna $5 117%
Florida Complete Care $5 117%
Longevity Health Plan $5 117%
Oscar $8 186%
Simply Healthcare $10 233%
Freedom Health $21 490%
Avmed $31 - $120 723%
Molina $46 1072%
Office Of Sheiff Highland Co $84 1958%
Prime Health $92 2145%
United Ppo $106 2471%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3600 S Highlands Ave, Sebring, FL 33870
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals