CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: HCA Florida Palms West Hospital

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85610
  • Insurance Median: $103
  • Cash Discount Price: $972
  • vs. Medicare Baseline: 24.01x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at HCA Florida Palms West Hospital is $103. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $972. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 24.01x the Medicare baseline. Located in 13001 Southern Blvd, Loxahatchee, FL.
Cash / Self-Pay
$972

Average discount available for prompt cash payment at this facility.

Insurance Median
$103

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: $972 (22657%)
Insurance Median: $103 (2401%)
Cash: $972 (22657% of Medicare)
Ins. Median: $103 (2401% 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 2401% of the Medicare baseline (a markup of 2301%). 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 - $292 93%
Blue Cross Blue Shield $4 93%
Careplus Sfl $4 93%
Devoted Health $4 93%
Humana $4 - $330 93%
Ndms Definitive Care $4 93%
Oscar $4 - $6 93%
Prominence Healthfirst $4 93%
Sunshine State $4 - $5 93%
United $4 - $437 93%
Veterans Evaluation Services $4 93%
Wellmed $4 93%
Align $5 117%
American Health Plan $5 117%
Amerihealth Caritas $5 - $6 117%
Centurion $5 117%
Cigna $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%
Freedom Health $84 - $156 1958%
Optimum $84 1958%
Corvel Corporation $103 2401%
Careworks (Rockport) $105 2448%
Prime Health $105 2448%
Avmed $126 - $486 2937%
Simply Healthcare Plans $126 2937%
Molina $185 - $262 4312%
Health Sun Health Plan $207 4825%
Aids Healthcare $214 - $1,166 4988%
Mmm Of Fl (Health Advantage Plan) $224 5221%
United Ppo $230 5361%
Sunshine State Health Plan $253 5897%
Health Care District $486 11329%
Palm Beach Juvenile Correction $486 11329%
Plotkin Health $486 11329%
Prime Health Sherriff $486 11329%
Healthy Palm Beaches $550 12821%
Medica Healthcare $564 13147%
Multiplan $729 - $826 16993%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 13001 Southern Blvd, Loxahatchee, FL 33470
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals