CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: HCA Florida Jfk Hospital

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85610
  • Insurance Median: $38
  • Cash Discount Price: $353
  • vs. Medicare Baseline: 8.86x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at HCA Florida Jfk Hospital is $38. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $353. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 8.86x the Medicare baseline. Located in 5301 S Congress Ave, Atlantis, FL.
Cash / Self-Pay
$353

Average discount available for prompt cash payment at this facility.

Insurance Median
$38

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: $353 (8228%)
Insurance Median: $38 (886%)
Cash: $353 (8228% of Medicare)
Ins. Median: $38 (886% 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 886% of the Medicare baseline (a markup of 786%). 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 - $106 93%
Blue Cross Blue Shield $4 93%
Careplus Sfl $4 93%
Devoted Health $4 93%
Humana $4 - $120 93%
Ndms Definitive Care $4 93%
Oscar $4 - $6 93%
Palm Beach Pace $4 93%
Prominence Healthfirst $4 93%
Sunshine State $4 - $5 93%
United $4 - $159 93%
United Behavioral Health $4 93%
Veterans Evaluation Services $4 93%
Wellmed $4 93%
Align $5 117%
American Health Plan $5 117%
Amerihealth Caritas $5 - $6 117%
Centurion $5 117%
Cigna $5 117%
Doctors Healthcare Plan $5 117%
Florida Complete Care $5 117%
Gold Kidney $5 117%
Longevity Health Plan $5 117%
Simply Healthcare $5 117%
Solis Health Plan $6 140%
Freedom Health $30 - $56 699%
Optimum $30 699%
Avmed $46 - $176 1072%
Simply Healthcare Plans $46 1072%
Molina $60 - $95 1399%
Health Sun Health Plan $75 1748%
Aids Healthcare $78 - $424 1818%
Mmm Of Fl (Health Advantage Plan) $81 1888%
United Ppo $84 1958%
Sunshine State Health Plan $92 2145%
Corvel Corporation $103 2401%
Careworks (Rockport) $105 2448%
Prime Health $105 2448%
Blis $124 2890%
District Cares $176 4103%
Plotkin Health $176 4103%
Prime Health Sherriff $176 4103%
Medica Healthcare $208 4848%
Multiplan $265 - $300 6177%
Evernorth Bh $282 6573%
Healthy Palm Beaches $550 12821%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 5301 S Congress Ave, Atlantis, FL 33462
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals