CMS Price Transparency Data

Blood transfusion

Facility: Gulf Breeze Hospital

Billing Code: 36430 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 36430
Insurance Median: $570
Cash Discount Price: $285
vs. Medicare Baseline: 1.26x Medicare

The contracted insurance negotiated median rate for a Blood transfusion at Gulf Breeze Hospital is $570. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $285. Compared to the federal Medicare reimbursement reference rate of $450.73, this hospital’s rate is 1.26x the Medicare baseline. Located in 1110 Gulf Breeze Pkwy, Gulf Breeze, FL.

Cash / Self-Pay

$285

Average discount available for prompt cash payment at this facility.

Insurance Median

$570

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$450.73

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $450.73 (100%)

Cash / Self-Pay: $285 (63%)

Insurance Median: $570 (126%)

Cash: $285 (63% of Medicare)

Ins. Median: $570 (126% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $450.73 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
Aetna	$279 - $1,387	62%
Cha Health Plan	$279	62%
UnitedHealthcare	$279 - $504	62%
Pensacola	$285	63%
Humana	$293 - $448	65%
Sunshine Health	$293	65%
Wellcare	$293 - $461	65%
Fl Community Care Ltc	$298	66%
Simply Healthcare Healthy Kids	$321	71%
Medicare (plans)	$365	81%
Hospice Covenant	$439	97%
Hospice Regency	$570	126%
Fl Blue	$733 - $2,638	163%
Cigna	$902 - $1,900	200%
Hospice Emerald Coast	$950	211%
Private Healthcare	$1,235	274%
Uwf Athletes	$1,235	274%
First Health	$1,320	293%
Wc Corvel	$1,354 - $1,805	300%
Choicecare	$1,425	316%
Bc Fl	$1,601	355%
Multiplan	$1,691	375%

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 $285.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 36430.

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 36430.
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.