CMS Price Transparency Data

Blood test, sodium

Facility: Adventist Health Tillamook

Billing Code: 84295 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84295
Insurance Median: $44
Cash Discount Price: $46
vs. Medicare Baseline: 9.15x Medicare

The contracted insurance negotiated median rate for a Blood test, sodium at Adventist Health Tillamook is $44. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $46. Compared to the federal Medicare reimbursement reference rate of $4.81, this hospital’s rate is 9.15x the Medicare baseline. Located in 1000 Third Street, Tillamook, OR.

Cash / Self-Pay

$46

Average discount available for prompt cash payment at this facility.

Insurance Median

$44

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$4.81

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $4.81 (100%)

Cash / Self-Pay: $46 (956%)

Insurance Median: $44 (915%)

Cash: $46 (956% of Medicare)

Ins. Median: $44 (915% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $4.81 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 915% of the Medicare baseline (a markup of 815%). 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	$11 - $77	229%
Hvhs Mcare - All Plans	$11 - $42	229%
Medicare (plans)	$11 - $42	229%
Moda Health Plan - All Plans	$11 - $42	229%
Sterling Life - All Plans	$11 - $44	229%
Aetna	$12 - $83	249%
Devoted Health	$12 - $45	249%
Lifewise - All Plans	$21 - $80	437%
Ah Employee Health Plan - All Plans	$22 - $84	457%
Cigna	$22 - $85	457%
First Choice Health- All Plans	$22 - $84	457%
Health Net - All Plans	$22 - $84	457%
Ods Health Plan - All Other Plans	$22 - $86	457%
Pacificsource - All Plans	$22 - $85	457%
Phcs Preferred - All Plans	$22 - $85	457%
UnitedHealthcare	$22 - $85	457%
Providence Preferred - All Plans	$23 - $87	478%
Workers Comp	$23 - $89	478%

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 $46.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 84295.

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 84295.
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.