CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Gulf Breeze Hospital

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80053
Insurance Median: $36
Cash Discount Price: $36
vs. Medicare Baseline: 3.41x Medicare

The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Gulf Breeze Hospital is $36. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $36. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 3.41x the Medicare baseline. Located in 1110 Gulf Breeze Pkwy, Gulf Breeze, FL.

Cash / Self-Pay

$36

Average discount available for prompt cash payment at this facility.

Insurance Median

$36

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$10.56

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $10.56 (100%)

Cash / Self-Pay: $36 (341%)

Insurance Median: $36 (341%)

Cash: $36 (341% of Medicare)

Ins. Median: $36 (341% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $10.56 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 341% of the Medicare baseline (a markup of 241%). 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
Aetna	$5 - $175	47%
Cha Health Plan	$5	47%
Fl Community Care Ltc	$5	47%
Humana	$5 - $11	47%
Sunshine Health	$5	47%
UnitedHealthcare	$5 - $11	47%
Wellcare	$5 - $11	47%
Simply Healthcare Healthy Kids	$6	57%
Hospice Covenant	$11	104%
Medicare (plans)	$11	104%
Fl Blue	$18 - $333	170%
Pensacola	$36	341%
Hospice Regency	$72	682%
Cigna	$114 - $240	1080%
Hospice Emerald Coast	$120	1136%
Private Healthcare	$156	1477%
Uwf Athletes	$156	1477%
First Health	$167	1581%
Choicecare	$180	1705%
Bc Fl	$208	1970%
Multiplan	$214	2027%
Wc Corvel	$228 - $282	2159%

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 $36.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 80053.

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 80053.
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.