CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: HCA Florida Twin Cities Hospital

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85610
  • Insurance Median: $16
  • Cash Discount Price: $424
  • vs. Medicare Baseline: 3.73x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at HCA Florida Twin Cities Hospital is $16. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $424. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 3.73x the Medicare baseline. Located in 2190 Hwy 85 N, Niceville, FL.
Cash / Self-Pay
$424

Average discount available for prompt cash payment at this facility.

Insurance Median
$16

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: $424 (9883%)
Insurance Median: $16 (373%)
Cash: $424 (9883% of Medicare)
Ins. Median: $16 (373% 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 373% of the Medicare baseline (a markup of 273%). 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 $4 - $244 93%
Blue Cross Blue Shield $4 93%
Humana $4 - $310 93%
Ndms Definitive Care $4 93%
Regency Hospice $4 93%
Sunshine State $4 93%
United $4 - $367 93%
Wellcare $4 93%
Wellmed $4 93%
American Health Plan $5 117%
Centurion $5 117%
Clear Spring Health $5 117%
Florida Complete Care $5 117%
Gold Kidney Of Florida $5 117%
Healthspring Of Florida $5 117%
Longevity Health Plan $5 117%
Simply $5 - $126 117%
Ultimate Health Plan $5 117%
Molina Healthcare $6 - $261 140%
Oscar $6 140%
Simply Healthcare $7 163%
Avmed $8 - $408 186%
Sunshine State Health Plan $8 - $208 186%
Plotkin Health $16 - $408 373%
Prime Health Sheriff $16 - $408 373%
Evolutions Healthcare $21 - $693 490%
Multiplan $25 - $693 583%
Ppo Next $27 - $693 629%
Novanet $29 - $734 676%
Corvel Corporation $99 2308%
Prime Health $101 2354%
Careworks (Rockport Community) $104 2424%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2190 Hwy 85 N, Niceville, FL 32578
  • CMS Rating: ★★★★★
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals