CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: Larkin Community Hospital Palm Springs Campus

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85610
  • Insurance Median: $148
  • Cash Discount Price: $141
  • vs. Medicare Baseline: 34.50x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at Larkin Community Hospital Palm Springs Campus is $148. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $141. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 34.50x the Medicare baseline. Located in 1475 W 49Th St, Hialeah, FL.
Cash / Self-Pay
$141

Average discount available for prompt cash payment at this facility.

Insurance Median
$148

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: $141 (3287%)
Insurance Median: $148 (3450%)
Cash: $141 (3287% of Medicare)
Ins. Median: $148 (3450% 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 3450% of the Medicare baseline (a markup of 3350%). 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 - $4 47%
Florida Community Care Mcaid-All Plans $2 47%
Miami Childrens Hp Mcaid-All Plans $2 47%
Simply Healthcare Mcaid $2 47%
Sunshine Mcaid $2 47%
United Mcaid $2 47%
Wellcare Mcaid $2 47%
Ambetter / Centene $4 93%
Blue Cross Blue Shield $4 - $172 93%
Clear Springs Health - All Plans $4 93%
Fdc - All Plans $4 93%
Medicare (plans) $4 - $225 93%
Opus Hospice Ip Only - All Plans $4 93%
Unicare Simply Mcare Ppo - All Plans $4 93%
Bright Health Commercial - All Other Plans $5 117%
Ccs - All Plans $6 140%
Cigna $44 - $56 1026%
Humana $53 - $225 1235%
Wellcare Comm (Choice) - All Other Plans $89 - $112 2075%
Leon Med Center Mcr Adv - All Plans $160 - $202 3730%
Careplus Health - All Other Plans $178 - $225 4149%
Centurion Doc - All Plans $178 - $225 4149%
Doctors Healthcare - All Plans $178 - $225 4149%
Florida Health Solution/Hmo - All Plans $178 - $225 4149%
Preferred Care Partners Mcr - All Plans $178 - $225 4149%
Simply Healthcare Mcr - All Other Plans $178 - $225 4149%
UnitedHealthcare $178 - $225 4149%
Naphcare - All Plans $205 - $259 4779%
Oscar Health-All Plans $356 - $450 8298%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1475 W 49Th St, Hialeah, FL 33012
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals