CMS Price Transparency Data

Blood test, clotting time (PT/INR)

Facility: Adventist Health Tillamook

Billing Code: 85610 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85610
Insurance Median: $42
Cash Discount Price: $31
vs. Medicare Baseline: 9.79x Medicare

The contracted insurance negotiated median rate for a Blood test, clotting time (PT/INR) at Adventist Health Tillamook is $42. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $31. Compared to the federal Medicare reimbursement reference rate of $4.29, this hospital’s rate is 9.79x the Medicare baseline. Located in 1000 Third Street, Tillamook, OR.

Cash / Self-Pay

$31

Average discount available for prompt cash payment at this facility.

Insurance Median

$42

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$4.29

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $4.29 (100%)

Cash / Self-Pay: $31 (723%)

Insurance Median: $42 (979%)

Cash: $31 (723% of Medicare)

Ins. Median: $42 (979% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $4.29 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 979% of the Medicare baseline (a markup of 879%). 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	$14 - $77	326%
Hvhs Mcare - All Plans	$14 - $42	326%
Medicare (plans)	$14 - $42	326%
Moda Health Plan - All Plans	$14 - $42	326%
Devoted Health	$15 - $45	350%
Sterling Life - All Plans	$15 - $44	350%
Aetna	$16 - $83	373%
Lifewise - All Plans	$27 - $80	629%
Ah Employee Health Plan - All Plans	$28 - $84	653%
Cigna	$28 - $85	653%
First Choice Health- All Plans	$28 - $84	653%
Health Net - All Plans	$28 - $84	653%
Phcs Preferred - All Plans	$28 - $85	653%
UnitedHealthcare	$28 - $85	653%
Ods Health Plan - All Other Plans	$29 - $86	676%
Pacificsource - All Plans	$29 - $85	676%
Providence Preferred - All Plans	$29 - $87	676%
Workers Comp	$30 - $89	699%

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 $31.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 85610.

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 85610.
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.