CMS Price Transparency Data

Blood test, complete blood count (CBC)

Facility: Adventist Health Tillamook

Billing Code: 85025 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85025
Insurance Median: $56
Cash Discount Price: $39
vs. Medicare Baseline: 7.21x Medicare

The contracted insurance negotiated median rate for a Blood test, complete blood count (CBC) at Adventist Health Tillamook is $56. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $39. Compared to the federal Medicare reimbursement reference rate of $7.77, this hospital’s rate is 7.21x the Medicare baseline. Located in 1000 Third Street, Tillamook, OR.

Cash / Self-Pay

$39

Average discount available for prompt cash payment at this facility.

Insurance Median

$56

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$7.77

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $7.77 (100%)

Cash / Self-Pay: $39 (502%)

Insurance Median: $56 (721%)

Cash: $39 (502% of Medicare)

Ins. Median: $56 (721% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $7.77 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 721% of the Medicare baseline (a markup of 621%). 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	$16 - $103	206%
Hvhs Mcare - All Plans	$16 - $56	206%
Medicare (plans)	$16 - $55	206%
Moda Health Plan - All Plans	$16 - $55	206%
Devoted Health	$17 - $60	219%
Sterling Life - All Plans	$17 - $58	219%
Aetna	$18 - $110	232%
Lifewise - All Plans	$31 - $106	399%
Ah Employee Health Plan - All Plans	$32 - $111	412%
Cigna	$32 - $112	412%
First Choice Health- All Plans	$32 - $111	412%
Health Net - All Plans	$32 - $111	412%
Phcs Preferred - All Plans	$32 - $112	412%
UnitedHealthcare	$32 - $112	412%
Ods Health Plan - All Other Plans	$33 - $114	425%
Pacificsource - All Plans	$33 - $113	425%
Providence Preferred - All Plans	$33 - $116	425%
Workers Comp	$34 - $118	438%

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 $39.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 85025.

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 85025.
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.