CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: Baptist Hospital

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85610
  • Insurance Median: $7
  • Cash Discount Price: $2
  • vs. Medicare Baseline: 1.63x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at Baptist Hospital is $7. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 1.63x the Medicare baseline. Located in 123 Baptist Way, Pensacola, FL.
Cash / Self-Pay
$2

Average discount available for prompt cash payment at this facility.

Insurance Median
$7

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: $2 (47%)
Insurance Median: $7 (163%)
Cash: $2 (47% of Medicare)
Ins. Median: $7 (163% 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.

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 $1 - $96 23%
UnitedHealthcare $1 - $4 23%
Cha Health Plan $2 47%
Fl Community Care Ltc $2 47%
Humana $2 - $4 47%
Mh Sunshine Mcaid $2 47%
Pensacola $2 - $20 47%
Staywell $2 47%
Sunshine Health $2 47%
Hospice Regency $3 - $39 70%
Simply Healthcare Healthy Kids $3 70%
Healthspring Of Fl Al $4 93%
Hospice Covenant $4 93%
Medicare (plans) $4 93%
Mh Wellcare $4 93%
Wellcare $4 93%
Cigna $5 - $131 117%
Hospice Emerald Coast $5 - $66 117%
Escambia $6 - $79 140%
Fl Blue $6 - $426 140%
Private Healthcare $6 - $85 140%
Uwf Athletes $6 - $85 140%
First Health $7 - $91 163%
Wc Corvel $7 - $124 163%
Choicecare $8 - $98 186%
Mh Choicecare $8 - $98 186%
Multiplan $9 - $117 210%
Bc Fl $305 7110%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 123 Baptist Way, Pensacola, FL 32503
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals