CMS Price Transparency Data

Blood test, complete blood count (CBC)

Facility: Gulf Breeze Hospital

Billing Code: 85025 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85025
Insurance Median: $21
Cash Discount Price: $21
vs. Medicare Baseline: 2.70x Medicare

The contracted insurance negotiated median rate for a Blood test, complete blood count (CBC) at Gulf Breeze Hospital is $21. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $21. Compared to the federal Medicare reimbursement reference rate of $7.77, this hospital’s rate is 2.70x the Medicare baseline. Located in 1110 Gulf Breeze Pkwy, Gulf Breeze, FL.

Cash / Self-Pay

$21

Average discount available for prompt cash payment at this facility.

Insurance Median

$21

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$7.77

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $7.77 (100%)

Cash / Self-Pay: $21 (270%)

Insurance Median: $21 (270%)

Cash: $21 (270% of Medicare)

Ins. Median: $21 (270% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $7.77 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 270% of the Medicare baseline (a markup of 170%). 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 - $8	13%
Aetna	$3 - $100	39%
Cha Health Plan	$3	39%
Fl Community Care Ltc	$3	39%
Humana	$3 - $8	39%
Sunshine Health	$3	39%
Wellcare	$3 - $8	39%
Simply Healthcare Healthy Kids	$4	51%
Hospice Covenant	$8	103%
Medicare (plans)	$8	103%
Fl Blue	$13 - $333	167%
Pensacola	$21	270%
Hospice Regency	$41	528%
Cigna	$65 - $137	837%
Hospice Emerald Coast	$68	875%
Private Healthcare	$89	1145%
Uwf Athletes	$89	1145%
First Health	$95	1223%
Choicecare	$103	1326%
Wc Corvel	$105 - $130	1351%
Multiplan	$122	1570%
Bc Fl	$208	2677%

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 $21.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 85025.

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 85025.
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.