CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: HCA Florida Raulerson Hospital

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85610
  • Insurance Median: $48
  • Cash Discount Price: $561
  • vs. Medicare Baseline: 11.19x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at HCA Florida Raulerson Hospital is $48. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $561. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 11.19x the Medicare baseline. Located in 1796 Hwy 441 North, Okeechobee, FL.
Cash / Self-Pay
$561

Average discount available for prompt cash payment at this facility.

Insurance Median
$48

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: $561 (13077%)
Insurance Median: $48 (1119%)
Cash: $561 (13077% of Medicare)
Ins. Median: $48 (1119% 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 1119% of the Medicare baseline (a markup of 1019%). 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 - $168 93%
Blue Cross Blue Shield $4 93%
Careplus $4 93%
Devoted Health $4 93%
Humana $4 - $224 93%
Ndms Definitive Care $4 93%
Prominence Healthfirst $4 93%
Sunshine State $4 - $5 93%
Ultimate Health Plan $4 93%
United $4 - $252 93%
Veterans Evaluation Services $4 93%
Wellmed $4 93%
American Health Plan $5 117%
Amerihealth Caritas $5 117%
Centurion $5 117%
Cigna $5 117%
Florida Complete Care $5 117%
Longevity Health Plan $5 117%
Solis Health Plan $6 140%
Oscar $8 186%
Simply Healthcare $10 233%
Freedom Health $48 - $90 1119%
Optimum $48 1119%
Avmed $73 - $280 1702%
Simply Healthcare Plans $73 1702%
Corvel Corporation $92 2145%
Careworks (Rockport) $94 2191%
Prime Health $94 2191%
Molina $107 - $151 2494%
Health Sun Health Plan $119 2774%
Sunshine State Health Plan $143 3333%
United Ppo $247 5758%
Plotkin Health $280 6527%
Prime Health Sherriff $280 6527%
Multiplan $421 - $477 9814%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1796 Hwy 441 North, Okeechobee, FL 34972
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals