CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: HCA Florida North Florida Hospital

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85610
  • Insurance Median: $30
  • Cash Discount Price: $525
  • vs. Medicare Baseline: 6.99x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at HCA Florida North Florida Hospital is $30. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $525. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 6.99x the Medicare baseline. Located in 6500 W Newberry Rd, Gainesville, FL.
Cash / Self-Pay
$525

Average discount available for prompt cash payment at this facility.

Insurance Median
$30

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: $525 (12238%)
Insurance Median: $30 (699%)
Cash: $525 (12238% of Medicare)
Ins. Median: $30 (699% 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 699% of the Medicare baseline (a markup of 599%). 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
Aetna $4 - $296 93%
Blue Cross Blue Shield $4 93%
Capital Health Plan $4 93%
Hospice Of North Central Fl $4 93%
Humana $4 - $197 93%
Ndms Definitive Care $4 93%
Sunshine State $4 93%
United $4 - $444 93%
United Behavioral Health $4 93%
Wellcare $4 93%
Wellmed $4 93%
Align Senior Care $5 117%
American Health Plan $5 117%
Centurion $5 117%
Cigna $5 117%
Clear Spring Health $5 117%
Florida Complete Care $5 117%
Gold Kidney Of Florida $5 117%
Longevity Health Plan $5 117%
Oscar $5 117%
Simply Healthcare $5 117%
Ultimate Health Plan $5 117%
Avmed $8 - $493 186%
Simply $10 - $152 233%
Molina Healthcare $12 - $316 280%
Evolutions $15 - $227 350%
Sunshine State Health Plan $16 - $252 373%
Plotkin Health $32 - $493 746%
Prime Health Sheriff $32 - $493 746%
Corizon Phs $38 - $592 886%
Multiplan $49 - $839 1142%
Evernorth $51 - $789 1189%
Evolutions Healthcare $54 - $839 1259%
Ppo Next $54 - $839 1259%
Novanet $57 - $888 1329%
Beacon Health Options $63 - $987 1469%
Corvel Corporation $103 2401%
Prime Health $106 2471%
Careworks (Rockport Community) $109 2541%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 6500 W Newberry Rd, Gainesville, FL 32605
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals