CMS Price Transparency Data

Blood antibody screen

Facility: Adventist Health Tillamook

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $67
Cash Discount Price: $66
vs. Medicare Baseline: 1.26x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at Adventist Health Tillamook is $67. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $66. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 1.26x the Medicare baseline. Located in 1000 Third Street, Tillamook, OR.

Cash / Self-Pay

$66

Average discount available for prompt cash payment at this facility.

Insurance Median

$67

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$53.24

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $53.24 (100%)

Cash / Self-Pay: $66 (124%)

Insurance Median: $67 (126%)

Cash: $66 (124% of Medicare)

Ins. Median: $67 (126% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $53.24 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
Blue Cross Blue Shield	$18 - $126	34%
Medicare (plans)	$18 - $68	34%
Moda Health Plan - All Plans	$18 - $68	34%
Hvhs Mcare - All Plans	$19 - $69	36%
Sterling Life - All Plans	$19 - $71	36%
Aetna	$20 - $135	38%
Devoted Health	$20 - $74	38%
Lifewise - All Plans	$35 - $131	66%
Ah Employee Health Plan - All Plans	$37 - $136	69%
Cigna	$37 - $138	69%
First Choice Health- All Plans	$37 - $136	69%
Health Net - All Plans	$37 - $136	69%
Pacificsource - All Plans	$37 - $139	69%
Phcs Preferred - All Plans	$37 - $138	69%
UnitedHealthcare	$37 - $138	69%
Ods Health Plan - All Other Plans	$38 - $141	71%
Providence Preferred - All Plans	$38 - $142	71%
Workers Comp	$39 - $145	73%

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 $66.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 86850.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Adventist Health Tillamook is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 86850.
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.