CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Gulf Breeze Hospital

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $1,048
Cash Discount Price: $861
vs. Medicare Baseline: 2.94x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Gulf Breeze Hospital is $1,048. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $861. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 2.94x the Medicare baseline. Located in 1110 Gulf Breeze Pkwy, Gulf Breeze, FL.

Cash / Self-Pay

$861

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,048

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$356.43

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $356.43 (100%)

Cash / Self-Pay: $861 (242%)

Insurance Median: $1,048 (294%)

Cash: $861 (242% of Medicare)

Ins. Median: $1,048 (294% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $356.43 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 294% of the Medicare baseline (a markup of 194%). 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	$259 - $4,189	73%
Cha Health Plan	$259	73%
UnitedHealthcare	$259 - $2,235	73%
Humana	$272 - $366	76%
Sunshine Health	$272	76%
Wellcare	$272 - $376	76%
Fl Community Care Ltc	$277	78%
Simply Healthcare Healthy Kids	$298	84%
Medicare (plans)	$338	95%
Hospice Covenant	$358	100%
Fl Blue	$599 - $2,156	168%
Pensacola	$861	242%
Uwf Athletes	$1,000 - $3,730	281%
Bc Fl	$1,309	367%
Hospice Regency	$1,721	483%
Cigna	$2,726 - $5,738	765%
Hospice Emerald Coast	$2,869	805%
Wc Corvel	$3,220 - $5,451	903%
Private Healthcare	$3,730	1046%
First Health	$3,988	1119%
Choicecare	$4,304	1208%
Multiplan	$5,107	1433%

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 $861.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 70553.

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 70553.
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.