Blood test, clotting time (PT/INR)
Facility: HCA Florida Northside Hospital
Billing Code: 85610 (CPT)
- CPT Billing Code: 85610
- Insurance Median: $22
- Cash Discount Price: $111
- vs. Medicare Baseline: 5.13x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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 513% of the Medicare baseline (a markup of 413%). 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Access 2 Healthcare Physicians Freedom Optimum Group Members | $4 - $49 | 93% |
| Aetna | $4 - $314 | 93% |
| Baycare Health Plans | $4 | 93% |
| Blue Cross Blue Shield | $4 | 93% |
| Caresource | $4 | 93% |
| Devoted Health | $4 | 93% |
| Humana | $4 - $293 | 93% |
| Ndms Definitive Care | $4 | 93% |
| Sunshine State | $4 | 93% |
| Ultimate Health Plan | $4 | 93% |
| United | $4 - $472 | 93% |
| United Va Ccn | $4 | 93% |
| Wellcare | $4 | 93% |
| Wellmed | $4 | 93% |
| Align Senior Care | $5 | 117% |
| American Health Plan | $5 | 117% |
| Careplus | $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% |
| Secur | $5 | 117% |
| Simply Healthcare | $5 - $161 | 117% |
| Access 2 Healthcare Physicians Freedom Health | $6 - $75 | 140% |
| Access 2 Healthcare Physicians Optimum | $6 - $75 | 140% |
| Avmed | $6 - $262 | 140% |
| Freedom Health Care | $6 - $82 | 140% |
| Optimum Healthcare | $6 - $82 | 140% |
| Oscar | $6 | 140% |
| Solis Health Plan | $6 | 140% |
| Suncoast Neighborly Care | $6 - $84 | 140% |
| Molina | $15 - $283 | 350% |
| Evolutions Healthcare Systems | $18 - $964 | 420% |
| Sunshine State Health Plan | $20 - $267 | 466% |
| Plotkin Health | $40 - $524 | 932% |
| Prime Health Sheriff | $40 - $524 | 932% |
| Multiplan | $60 - $891 | 1399% |
| Corvel Corporation | $99 | 2308% |
| Rockport Healthcare Group | $99 | 2308% |
| Prime Health | $102 | 2378% |