CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Adventist Health Tillamook

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $1,786
Cash Discount Price: $1,335
vs. Medicare Baseline: 7.33x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Adventist Health Tillamook is $1,786. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,335. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 7.33x the Medicare baseline. Located in 1000 Third Street, Tillamook, OR.

Cash / Self-Pay

$1,335

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,786

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$243.77

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $243.77 (100%)

Cash / Self-Pay: $1,335 (548%)

Insurance Median: $1,786 (733%)

Cash: $1,335 (548% of Medicare)

Ins. Median: $1,786 (733% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $243.77 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 733% of the Medicare baseline (a markup of 633%). 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	$53 - $3,523	22%
Aetna	$62 - $3,448	25%
Moda Health Plan - All Plans	$63 - $1,743	26%
Medicare (plans)	$65 - $1,743	27%
Sterling Life - All Plans	$65 - $1,812	27%
Devoted Health	$67 - $1,882	27%
Blue Cross Blue Shield	$71 - $3,226	29%
Hvhs Mcare - All Plans	$75 - $1,760	31%
Pacificsource - All Plans	$137 - $3,560	56%
Ods Health Plan - All Other Plans	$144 - $3,597	59%
Lifewise - All Plans	$401 - $3,345	164%
Ah Employee Health Plan - All Plans	$418 - $3,486	171%
First Choice Health- All Plans	$418 - $3,486	171%
Health Net - All Plans	$418 - $3,486	171%
Providence Preferred - All Plans	$436 - $3,634	179%
Workers Comp	$445 - $3,708	183%
Cigna	$2,348 - $3,523	963%
Phcs Preferred - All Plans	$2,348 - $3,523	963%

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 $1,335.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 73721.

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 73721.
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.