CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: HCA Florida Lawnwood Hospital

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85610
  • Insurance Median: $12
  • Cash Discount Price: $465
  • vs. Medicare Baseline: 2.80x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at HCA Florida Lawnwood Hospital is $12. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $465. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 2.80x the Medicare baseline. Located in 1700 S 23Rd St, Fort Pierce, FL.
Cash / Self-Pay
$465

Average discount available for prompt cash payment at this facility.

Insurance Median
$12

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: $465 (10839%)
Insurance Median: $12 (280%)
Cash: $465 (10839% of Medicare)
Ins. Median: $12 (280% 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 280% of the Medicare baseline (a markup of 180%). 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
Cigna $2 - $199 47%
Aetna $4 - $186 93%
Blue Cross Blue Shield $4 - $230 93%
Bright Health $4 - $93 93%
Careplus $4 93%
Delaware Life Insurance $4 93%
Devoted Health $4 93%
Humana $4 - $248 93%
Innovage Pace $4 93%
Kaiser $4 - $110 93%
Mutual Of Omaha $4 93%
Ndms Definitive Care $4 93%
Prominence Healthfirst $4 93%
Rocky Mountain Health $4 93%
Rocky Mountain Health Plan $4 93%
Sunshine State $4 - $5 93%
Total Longterm Care $4 93%
Triwest Health Alliance $4 93%
Ultimate Health Plan $4 93%
United $4 - $279 93%
United Behavioral Health $4 93%
Veterans Evaluation Services $4 93%
Wellcare $4 93%
Wellmed $4 93%
American Health Plan $5 117%
Amerihealth Caritas $5 117%
Centurion $5 117%
Florida Complete Care $5 117%
Longevity Health Plan $5 117%
Solis Health Plan $6 140%
Oscar $8 186%
Simply Healthcare $10 233%
Multiplan $12 - $526 280%
Pinnacol Workers Comp $12 280%
Vail Health $47 1096%
Freedom Health $53 - $99 1235%
Optimum $53 1235%
Avmed $80 - $310 1865%
Simply Healthcare Plans $80 1865%
Corvel Corporation $102 2378%
Careworks (Rockport) $104 2424%
Prime Health $104 - $280 2424%
Molina $118 - $167 2751%
Health Sun Health Plan $132 3077%
Sunshine State Health Plan $158 3683%
Western Plains Community Health $202 4709%
Office Of Sheiff Highland Co $217 5058%
Northcare $218 5082%
Physician Health Partners $218 5082%
Medical Development International $249 5804%
United Ppo $272 6340%
Plotkin Health $310 7226%
Prime Health Sherriff $310 7226%
Evernorth Bh $495 11538%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1700 S 23Rd St, Fort Pierce, FL 34950
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals