CMS Price Transparency Data

X-ray, pelvis

Facility: Gulf Breeze Hospital

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72170
Insurance Median: $190
Cash Discount Price: $114
vs. Medicare Baseline: 1.78x Medicare

The contracted insurance negotiated median rate for a X-ray, pelvis at Gulf Breeze Hospital is $190. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $114. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.78x the Medicare baseline. Located in 1110 Gulf Breeze Pkwy, Gulf Breeze, FL.

Cash / Self-Pay

$114

Average discount available for prompt cash payment at this facility.

Insurance Median

$190

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: $114 (107%)

Insurance Median: $190 (178%)

Cash: $114 (107% of Medicare)

Ins. Median: $190 (178% 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.

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	$36 - $556	34%
Cha Health Plan	$36	34%
UnitedHealthcare	$36 - $202	34%
Humana	$37 - $109	35%
Sunshine Health	$37	35%
Wellcare	$37 - $112	35%
Fl Community Care Ltc	$38	36%
Simply Healthcare Healthy Kids	$41	38%
Uwf Athletes	$50 - $495	47%
Medicare (plans)	$100	94%
Hospice Covenant	$107	100%
Pensacola	$114	107%
Fl Blue	$178 - $513	167%
Hospice Regency	$228	213%
Bc Fl	$317	297%
Wc Corvel	$346 - $723	324%
Cigna	$361 - $761	338%
Hospice Emerald Coast	$380	356%
Private Healthcare	$495	463%
First Health	$529	495%
Choicecare	$571	535%
Multiplan	$677	634%

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 $114.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 72170.

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 72170.
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.