CMS Price Transparency Data

Blood test, cholesterol (lipid panel)

Facility: Adventist Health Tillamook

Billing Code: 80061 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80061
Insurance Median: $98
Cash Discount Price: $75
vs. Medicare Baseline: 7.32x Medicare

The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at Adventist Health Tillamook is $98. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $75. Compared to the federal Medicare reimbursement reference rate of $13.39, this hospital’s rate is 7.32x the Medicare baseline. Located in 1000 Third Street, Tillamook, OR.

Cash / Self-Pay

$75

Average discount available for prompt cash payment at this facility.

Insurance Median

$98

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$13.39

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $13.39 (100%)

Cash / Self-Pay: $75 (560%)

Insurance Median: $98 (732%)

Cash: $75 (560% of Medicare)

Ins. Median: $98 (732% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $13.39 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 732% of the Medicare baseline (a markup of 632%). 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
Blue Cross Blue Shield	$30 - $177	224%
Hvhs Mcare - All Plans	$30 - $97	224%
Medicare (plans)	$30 - $96	224%
Moda Health Plan - All Plans	$30 - $96	224%
Sterling Life - All Plans	$31 - $100	232%
Devoted Health	$32 - $104	239%
Aetna	$33 - $190	246%
Lifewise - All Plans	$57 - $184	426%
Ah Employee Health Plan - All Plans	$59 - $192	441%
First Choice Health- All Plans	$59 - $192	441%
Health Net - All Plans	$59 - $192	441%
Cigna	$60 - $194	448%
Pacificsource - All Plans	$60 - $196	448%
Phcs Preferred - All Plans	$60 - $194	448%
UnitedHealthcare	$60 - $194	448%
Ods Health Plan - All Other Plans	$61 - $198	456%
Providence Preferred - All Plans	$62 - $200	463%
Workers Comp	$63 - $204	471%

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 $75.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 80061.

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 80061.
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.