CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: Baptist Health Medical Center - Jacksonville

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85610
  • Insurance Median: $21
  • Cash Discount Price: $49
  • vs. Medicare Baseline: 4.90x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at Baptist Health Medical Center - Jacksonville is $21. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $49. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 4.90x the Medicare baseline. Located in 800 Prudential Dr, Jacksonville, FL.
Cash / Self-Pay
$49

Average discount available for prompt cash payment at this facility.

Insurance Median
$21

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: $49 (1142%)
Insurance Median: $21 (490%)
Cash: $49 (1142% of Medicare)
Ins. Median: $21 (490% 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 490% of the Medicare baseline (a markup of 390%). 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
Amerigroup Of Georgia $2 47%
Amerihealth Caritas $2 47%
Caresource Of Georgia $2 - $47 47%
Daniel Memorial $2 47%
Florida Community Care $2 - $4 47%
Humana $2 47%
Peach State Health Plan $2 - $47 47%
Simply Healthcare Plans $2 - $3 47%
Simply Healthcare Plans - Cha $2 47%
Sunshine State Health Plan $2 47%
United Community Plan $2 47%
Vivida Health $2 47%
Aetna $3 - $58 70%
Molina Healthcare Of Florida $3 70%
Community Hospice Of Northeast Florida $4 93%
Corvel $4 - $71 93%
Coventry Workers Comp $4 - $71 93%
Non-Contracted $4 - $11 93%
Pace $4 93%
Tomorrow'S Rainbow $4 93%
UnitedHealthcare $4 - $38 93%
Va Ccn $4 93%
Devoted $5 117%
Upmc $5 117%
Ambetter / Centene $10 233%
Blue Cross Blue Shield $14 - $47 326%
Avmed $23 - $37 536%
Cigna $28 - $44 653%
Borland Groover $29 676%
Occunet $29 - $36 676%
Northeast Florida State Hospital $30 - $34 699%
Centivo $32 - $61 746%
Capital Health Plan $33 769%
Innovative Healthware Services $34 793%
Geo Group $36 839%
Volusia Health Network $40 932%
Watchtower $40 932%
Fscj Student Insurance $43 1002%
Suddath Company $45 1049%
Medicaid / KanCare $47 1096%
Uf Health Proton Therapy Institute $50 1166%
Phcs $54 - $58 1259%
Evolutions Healthcare $65 1515%
Multiplan $65 1515%
Nemours Research $983 22914%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 800 Prudential Dr, Jacksonville, FL 32207
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals