CMS Price Transparency Data

C-section delivery (full package)

Facility: Adventist Health Tillamook

Billing Code: 59510 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 59510
Insurance Median: $4,962
Cash Discount Price: $5,451
vs. Medicare Baseline: 2.01x Medicare

The contracted insurance negotiated median rate for a C-section delivery (full package) at Adventist Health Tillamook is $4,962. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,451. Compared to the federal Medicare reimbursement reference rate of $2,473.27, this hospital’s rate is 2.01x the Medicare baseline. Located in 1000 Third Street, Tillamook, OR.

Cash / Self-Pay

$5,451

Average discount available for prompt cash payment at this facility.

Insurance Median

$4,962

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$2,473.27

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $2,473.27 (100%)

Cash / Self-Pay: $5,451 (220%)

Insurance Median: $4,962 (201%)

Cash: $5,451 (220% of Medicare)

Ins. Median: $4,962 (201% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $2,473.27 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 201% of the Medicare baseline (a markup of 101%). 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
Aetna	$2,342 - $3,280	95%
Moda Health Plan - All Plans	$2,389	97%
Sterling Life - All Plans	$2,435	98%
Medicare (plans)	$2,459	99%
Devoted Health	$2,529	102%
Blue Cross Blue Shield	$2,693 - $8,782	109%
Hvhs Mcare - All Plans	$2,833	115%
Pacificsource - All Plans	$3,833	155%
UnitedHealthcare	$4,962	201%
Ods Health Plan - All Other Plans	$5,118	207%
Lifewise - All Plans	$9,105	368%
Ah Employee Health Plan - All Plans	$9,488	384%
First Choice Health- All Plans	$9,488	384%
Health Net - All Plans	$9,488	384%
Providence Preferred - All Plans	$9,892	400%
Workers Comp	$10,094	408%

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 $5,451.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 59510.

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 59510.
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.