CMS Price Transparency Data

CT scan, pelvis

Facility: Gulf Breeze Hospital

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72192
Insurance Median: $870
Cash Discount Price: $870
vs. Medicare Baseline: 8.15x Medicare

The contracted insurance negotiated median rate for a CT scan, pelvis at Gulf Breeze Hospital is $870. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $870. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 8.15x the Medicare baseline. Located in 1110 Gulf Breeze Pkwy, Gulf Breeze, FL.

Cash / Self-Pay

$870

Average discount available for prompt cash payment at this facility.

Insurance Median

$870

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$106.81

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $106.81 (100%)

Cash / Self-Pay: $870 (815%)

Insurance Median: $870 (815%)

Cash: $870 (815% of Medicare)

Ins. Median: $870 (815% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $106.81 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 815% of the Medicare baseline (a markup of 715%). 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	$68 - $4,234	64%
Cha Health Plan	$68	64%
UnitedHealthcare	$68 - $1,900	64%
Humana	$72 - $109	67%
Sunshine Health	$72	67%
Wellcare	$72 - $112	67%
Fl Community Care Ltc	$73	68%
Simply Healthcare Healthy Kids	$79	74%
Medicare (plans)	$100	94%
Hospice Covenant	$107	100%
Fl Blue	$178 - $1,676	167%
Uwf Athletes	$330	309%
Pensacola	$870	815%
Bc Fl	$1,043	977%
Hospice Regency	$1,740	1629%
Wc Corvel	$2,170 - $5,510	2032%
Cigna	$2,755 - $5,800	2579%
Hospice Emerald Coast	$2,900	2715%
Private Healthcare	$3,770	3530%
First Health	$4,031	3774%
Choicecare	$4,350	4073%
Multiplan	$5,162	4833%

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 $870.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 72192.

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 72192.
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.