CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: HCA Florida Orange Park Hospital

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85610
  • Insurance Median: $23
  • Cash Discount Price: $414
  • vs. Medicare Baseline: 5.36x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at HCA Florida Orange Park Hospital is $23. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $414. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 5.36x the Medicare baseline. Located in 2001 Kingsley Ave, Orange Park, FL.
Cash / Self-Pay
$414

Average discount available for prompt cash payment at this facility.

Insurance Median
$23

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: $414 (9650%)
Insurance Median: $23 (536%)
Cash: $414 (9650% of Medicare)
Ins. Median: $23 (536% 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 536% of the Medicare baseline (a markup of 436%). 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
Hospice Community $3 70%
Blue Cross Blue Shield $4 93%
Careplus $4 93%
Devoted Health $4 93%
Hospice Haven $4 93%
Humana $4 - $308 93%
Ndms Definitive Care $4 93%
Sunshine State $4 93%
United $4 - $338 93%
United Behavioral Health $4 93%
Veterans Evaluation Services $4 93%
Wellcare $4 93%
Wellmed $4 93%
American Health Plan $5 117%
Cigna $5 117%
Clay County Sheriffs Office $5 117%
Florida Complete Care $5 117%
Gold Kidney $5 117%
Longevity $5 117%
Simply Healthcare $5 - $116 117%
Optimum Healthcare $6 - $63 140%
Oscar $6 140%
Avmed $9 - $211 210%
Positive Healthcare $17 - $165 396%
Sunshine State Health Plan $19 - $192 443%
Molina Healthcare $21 - $203 490%
Aetna $23 - $226 536%
Medicare (plans) $34 - $338 793%
Plotkin Health $38 - $376 886%
Multiplan $59 - $639 1375%
Evernorth $61 - $602 1422%
Evolutions Healthcare $61 - $639 1422%
Ppo Next $65 - $639 1515%
Novanet $68 - $677 1585%
Corvel Corporation $98 2284%
Prime Health $100 2331%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2001 Kingsley Ave, Orange Park, FL 32073
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals