CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Adventist Health Tillamook

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $2,436
Cash Discount Price: $2,256
vs. Medicare Baseline: 6.83x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Adventist Health Tillamook is $2,436. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,256. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 6.83x the Medicare baseline. Located in 1000 Third Street, Tillamook, OR.

Cash / Self-Pay

$2,256

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,436

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$356.43

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $356.43 (100%)

Cash / Self-Pay: $2,256 (633%)

Insurance Median: $2,436 (683%)

Cash: $2,256 (633% of Medicare)

Ins. Median: $2,436 (683% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $356.43 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 683% of the Medicare baseline (a markup of 583%). 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
UnitedHealthcare	$88 - $4,735	25%
Aetna	$104 - $4,635	29%
Moda Health Plan - All Plans	$106 - $2,342	30%
Sterling Life - All Plans	$108 - $2,436	30%
Medicare (plans)	$109 - $2,342	31%
Devoted Health	$112 - $2,530	31%
Blue Cross Blue Shield	$119 - $4,336	33%
Hvhs Mcare - All Plans	$126 - $2,366	35%
Pacificsource - All Plans	$240 - $4,785	67%
Ods Health Plan - All Other Plans	$244 - $4,834	68%
Lifewise - All Plans	$676 - $4,496	190%
Ah Employee Health Plan - All Plans	$705 - $4,685	198%
First Choice Health- All Plans	$705 - $4,685	198%
Health Net - All Plans	$705 - $4,685	198%
Providence Preferred - All Plans	$735 - $4,884	206%
Workers Comp	$750 - $4,984	210%
Cigna	$3,968 - $4,735	1113%
Phcs Preferred - All Plans	$3,968 - $4,735	1113%

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 $2,256.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 70553.

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 70553.
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.