CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: North Okaloosa Medical Center

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85610
  • Insurance Median: $15
  • Cash Discount Price: $41
  • vs. Medicare Baseline: 3.50x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at North Okaloosa Medical Center is $15. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $41. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 3.50x the Medicare baseline. Located in 151 Redstone Ave Se, Crestview, FL.
Cash / Self-Pay
$41

Average discount available for prompt cash payment at this facility.

Insurance Median
$15

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: $41 (956%)
Insurance Median: $15 (350%)
Cash: $41 (956% of Medicare)
Ins. Median: $15 (350% 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 350% of the Medicare baseline (a markup of 250%). 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 $2 47%
Humana $2 - $4 47%
Integral Health $2 47%
Magellan Health $2 47%
Medicaid / KanCare $2 47%
Simply Healthcare $2 - $4 47%
UnitedHealthcare $2 - $77 47%
Wellcare $2 - $4 47%
Prestige Health $3 70%
Aetna $4 - $290 93%
Amcomp Workers Comp $4 93%
Blue Cross Blue Shield $4 - $387 93%
Cigna $4 - $302 93%
Evolutions $4 - $340 93%
Medicare (plans) $4 93%
Node Champva $4 93%
Node Non Par Hospice Agree $4 93%
Node Va $4 93%
Prime Health Work Comp Fl $4 93%
Tricare $4 93%
Usa Managed Care Work Comp Fl $4 93%
Veterans Eval Services $4 93%
Florida Department Of Corrections $5 117%
Node Us Dept Of Labor $5 117%
Oscar $6 140%
Self Pay $8 - $104 186%
State Auto Insurance Fl $9 210%
Occunet $11 256%
Corizon Health Inc $14 - $131 326%
Phcs $39 - $348 909%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 151 Redstone Ave Se, Crestview, FL 32539
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals