CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: University of Miami Hospital and Clinics

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85610
Insurance Median: $97
Cash Discount Price: $64
vs. Medicare Baseline: 22.61x Medicare

The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at University of Miami Hospital and Clinics is $97. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $64. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 22.61x the Medicare baseline. Located in 1475 Nw 12Th Ave Suite 2175, Miami, FL.

Cash / Self-Pay

$64

Average discount available for prompt cash payment at this facility.

Insurance Median

$97

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: $64 (1492%)

Insurance Median: $97 (2261%)

Cash: $64 (1492% of Medicare)

Ins. Median: $97 (2261% 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 2261% of the Medicare baseline (a markup of 2161%). 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
UnitedHealthcare	$4 - $19	93%
Aetna	$5 - $213	117%
Humana	$5	117%
Solis Health	$5	117%
Careplus	$9 - $97	210%
Sunshine Health	$9 - $97	210%
Amerihealth Caritas Fl	$10 - $109	233%
Molina Healthcare Of Fl	$10 - $105	233%
Oscar Health Of Fl	$10 - $109	233%
Blue Cross Blue Shield	$11 - $370	256%
Cigna	$13 - $169	303%
Curative	$19 - $206	443%
Avmed	$21 - $252	490%
Employers Health Network	$22 - $233	513%
Simply Healthcare	$22 - $233	513%
First Health	$23 - $252	536%
Health First New York Health Insurance	$23 - $252	536%
Broward Health	$25 - $272	583%
Beech Street	$29 - $310	676%
Dimension Health	$29 - $310	676%
Multiplan	$29 - $310	676%

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 $64.
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 University of Miami Hospital and Clinics 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.