CMS Price Transparency Data

Blood test, clotting time (PTT)

Facility: Gulf Breeze Hospital

Billing Code: 85730 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85730
Insurance Median: $25
Cash Discount Price: $8
vs. Medicare Baseline: 4.16x Medicare

The contracted insurance negotiated median rate for a Blood test, clotting time (PTT) at Gulf Breeze Hospital is $25. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $8. Compared to the federal Medicare reimbursement reference rate of $6.01, this hospital’s rate is 4.16x the Medicare baseline. Located in 1110 Gulf Breeze Pkwy, Gulf Breeze, FL.

Cash / Self-Pay

Average discount available for prompt cash payment at this facility.

Insurance Median

$25

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$6.01

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $6.01 (100%)

Cash / Self-Pay: $8 (133%)

Insurance Median: $25 (416%)

Cash: $8 (133% of Medicare)

Ins. Median: $25 (416% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $6.01 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 416% of the Medicare baseline (a markup of 316%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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 - $6	17%
Aetna	$2 - $128	33%
Cha Health Plan	$2	33%
Fl Community Care Ltc	$2	33%
Hospice Regency	$2 - $52	33%
Humana	$2 - $6	33%
Sunshine Health	$2	33%
Wellcare	$2 - $6	33%
Cigna	$3 - $175	50%
Hospice Emerald Coast	$3 - $88	50%
Simply Healthcare Healthy Kids	$3	50%
Choicecare	$4 - $131	67%
First Health	$4 - $122	67%
Private Healthcare	$4 - $114	67%
Uwf Athletes	$4 - $114	67%
Multiplan	$5 - $156	83%
Hospice Covenant	$6	100%
Medicare (plans)	$6	100%
Wc Corvel	$6 - $166	100%
Pensacola	$8 - $26	133%
Fl Blue	$10 - $333	166%
Bc Fl	$208	3461%

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 $8.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 85730.

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 85730.
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.