CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: Baptist Medical Center - Nassau

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85610
  • Insurance Median: $28
  • Cash Discount Price: $45
  • vs. Medicare Baseline: 6.53x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at Baptist Medical Center - Nassau is $28. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $45. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 6.53x the Medicare baseline. Located in 1250 S 18Th St, Fernandina Beach, FL.
Cash / Self-Pay
$45

Average discount available for prompt cash payment at this facility.

Insurance Median
$28

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: $45 (1049%)
Insurance Median: $28 (653%)
Cash: $45 (1049% of Medicare)
Ins. Median: $28 (653% 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 653% of the Medicare baseline (a markup of 553%). 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%
Daniel Memorial $2 47%
Florida Community Care $2 - $4 47%
Humana $2 47%
Nassaua County Sheriff'S Office $2 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%
Pace $4 93%
Tomorrow'S Rainbow $4 93%
UnitedHealthcare $4 - $35 93%
Va Ccn $4 93%
Devoted $5 117%
Upmc $5 117%
Ambetter / Centene $10 233%
Blue Cross Blue Shield $21 - $47 490%
Avmed $23 - $54 536%
Borland Groover $29 676%
Occunet $29 676%
Northeast Florida State Hospital $30 699%
Centivo $32 - $61 746%
Capital Health Plan $33 769%
Geo Group $36 839%
Watchtower $40 932%
Fscj Student Insurance $43 1002%
Savannah Grand Of Amelia Island $43 1002%
Cigna $45 - $55 1049%
Suddath Company $45 1049%
Medicaid / KanCare $47 1096%
Peach State Health Plan $47 1096%
Phcs $54 1259%
Evolutions Healthcare $65 1515%
Multiplan $65 1515%
Corvel $71 1655%
Coventry Workers Comp $71 1655%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1250 S 18Th St, Fernandina Beach, FL 32034
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals