CMS Price Transparency Data

Blood antibody screen

Facility: Gulf Breeze Hospital

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $66
Cash Discount Price: $54
vs. Medicare Baseline: 1.24x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at Gulf Breeze Hospital is $66. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $54. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 1.24x the Medicare baseline. Located in 1110 Gulf Breeze Pkwy, Gulf Breeze, FL.

Cash / Self-Pay

$54

Average discount available for prompt cash payment at this facility.

Insurance Median

$66

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$53.24

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $53.24 (100%)

Cash / Self-Pay: $54 (101%)

Insurance Median: $66 (124%)

Cash: $54 (101% of Medicare)

Ins. Median: $66 (124% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $53.24 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.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
UnitedHealthcare	$1 - $54	2%
Aetna	$2 - $265	4%
Cha Health Plan	$2	4%
Fl Community Care Ltc	$2	4%
Humana	$2 - $55	4%
Sunshine Health	$2	4%
Wellcare	$2 - $56	4%
Simply Healthcare Healthy Kids	$3	6%
Medicare (plans)	$46	86%
Hospice Covenant	$54	101%
Pensacola	$54	101%
Wc Corvel	$66 - $345	124%
Fl Blue	$90 - $333	169%
Hospice Regency	$109	205%
Cigna	$172 - $363	323%
Hospice Emerald Coast	$182	342%
Bc Fl	$208	391%
Private Healthcare	$236	443%
Uwf Athletes	$236	443%
First Health	$252	473%
Choicecare	$272	511%
Multiplan	$323	607%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $54.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 86850.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Gulf Breeze Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 86850.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.