CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: HCA Florida Kendall Hospital

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85610
  • Insurance Median: $56
  • Cash Discount Price: $786
  • vs. Medicare Baseline: 13.05x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at HCA Florida Kendall Hospital is $56. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $786. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 13.05x the Medicare baseline. Located in 11750 Bird Rd, Miami, FL.
Cash / Self-Pay
$786

Average discount available for prompt cash payment at this facility.

Insurance Median
$56

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: $786 (18322%)
Insurance Median: $56 (1305%)
Cash: $786 (18322% of Medicare)
Ins. Median: $56 (1305% 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 1305% of the Medicare baseline (a markup of 1205%). 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 - $407 93%
Blue Cross Blue Shield $4 93%
Careplus Sfl $4 93%
Cigna $4 93%
Devoted Health $4 93%
Humana $4 - $461 93%
Leon Health $4 93%
Ndms Definitive Care $4 93%
Oscar $4 - $6 93%
Prominence Healthfirst $4 93%
Sunshine State $4 - $5 93%
United $4 - $610 93%
United Behavioral Health $4 93%
Veterans Evaluation Services $4 93%
Wellmed $4 93%
Align $5 117%
American Health Plan $5 117%
Amerihealth Caritas $5 - $6 117%
Avmed $5 - $678 117%
Centurion $5 117%
Doctors Healthcare Plan $5 117%
Florida Complete Care $5 117%
Gold Kidney $5 117%
Longevity Health Plan $5 117%
Simply Healthcare $5 117%
Solis Health Plan $6 140%
Naphcare $7 163%
Seven Corners $9 - $10 210%
Wellpath $9 - $10 210%
Freedom Health $19 - $217 443%
Optimum $19 - $117 443%
Simply Healthcare Plans $28 - $176 653%
Molina $41 - $366 956%
Health Sun Health Plan $46 - $289 1072%
Aids Healthcare $48 - $1,627 1119%
Mmm Of Fl (Health Advantage Plan) $50 - $312 1166%
United Ppo $51 - $321 1189%
Sunshine State Health Plan $56 - $353 1305%
Corvel Corporation $107 2494%
Plotkin Health $108 - $678 2517%
Prime Health Sherriff $108 - $678 2517%
Careworks (Rockport) $109 2541%
Prime Health $109 2541%
Medica Healthcare $125 - $786 2914%
Multiplan $162 - $1,153 3776%
Evernorth Bh $173 - $1,085 4033%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 11750 Bird Rd, Miami, FL 33175
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals