CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: Palmetto General Hospital

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85610
  • Insurance Median: $5
  • Cash Discount Price: $253
  • vs. Medicare Baseline: 1.17x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at Palmetto General Hospital is $5. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $253. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 1.17x the Medicare baseline. Located in 2001 W 68Th St, Hialeah, FL.
Cash / Self-Pay
$253

Average discount available for prompt cash payment at this facility.

Insurance Median
$5

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: $253 (5897%)
Insurance Median: $5 (117%)
Cash: $253 (5897% of Medicare)
Ins. Median: $5 (117% 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
Cigna $2 - $126 47%
Humana $2 - $103 47%
Medicaid / KanCare $2 - $253 47%
UnitedHealthcare $2 - $4 47%
Veterans Administration Mill Bill $3 70%
Aetna $4 - $180 93%
Avmed Broad Network $4 93%
Bristol Hospice- Miami Dade Llc $4 93%
Catholic Hospice $4 93%
Compassionate Care Hospice Of Miami Dade And The Fl Keys Inc $4 93%
Devoted Health $4 93%
Dimension Health Wc $4 93%
Employer Direct Healthcare $4 - $5 93%
Healthsun Health Plans $4 93%
Hospice Other $4 93%
Ima Evalutations Inc $4 93%
Leon Health Inc $4 93%
Longevity Health Plan $4 93%
Medicare (plans) $4 - $253 93%
Odyssey Healthcare Of Marion County Dba Kindred Hospice $4 93%
Opuscare Of South Fl $4 93%
Seasons Hospice And Pallative Care Of Southern Florida Inc $4 93%
Select Specialty Hospital $4 93%
Tricare $4 93%
Veterans Administration Vaccn $4 93%
Vitas Healthcare Hospice $4 93%
Westchester General Hospital $4 93%
Workers Compensation $4 93%
Bright Health Management Commercial $5 117%
Florida Pace Centers $5 117%
Imagine Health $5 117%
Oscar Health Plan Hix $5 117%
Self Pay/Uninsured $5 117%
Naphcare Inc $6 140%
Ambetter / Centene $8 186%
Avmed Exchange $8 186%
Molina Marketplace Program Exchange $8 186%
Amerihealth Caritas Next Exchange $9 210%
Auto Insurance $9 210%
Avmed Select Network $9 210%
Bc/Bs Myblue Hmo Hix $36 839%
Bc/Bs Of Fl Network Blue $36 839%
Bc/Bs Of Fl Simplyblue $36 839%
Bc/Bs Of Fl Blue Select Exchange Non Par $39 909%
Bc/Bs Of Fl Health Options Hmo $39 909%
Bc/Bs Of Fl Ppo $39 909%
Bc/Bs Of Fl Miami Dade Blue Select $51 1189%
Liga Contra El Cancer $126 2937%
Bc/Bs Of Fl Phs $127 2960%
Magellan Behavioral Health $152 3543%
Dimensions International $164 3823%
First Health $169 3939%
Dimension Health Ppo $190 4429%
Beacon Health Strategies Commercial $253 5897%
Commercial Non-Contracted $253 5897%
Self Pay - Mcd Pending 100 Percent $253 5897%
Single Case Agreement $253 5897%
United Behavioral Health Psych $253 5897%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2001 W 68Th St, Hialeah, FL 33016
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals