CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Adventist Health Tillamook

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72148
Insurance Median: $1,389
Cash Discount Price: $1,445
vs. Medicare Baseline: 5.70x Medicare

The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Adventist Health Tillamook is $1,389. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,445. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 5.70x the Medicare baseline. Located in 1000 Third Street, Tillamook, OR.

Cash / Self-Pay

$1,445

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,389

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: $1,445 (593%)

Insurance Median: $1,389 (570%)

Cash: $1,445 (593% of Medicare)

Ins. Median: $1,389 (570% 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 570% of the Medicare baseline (a markup of 470%). 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	$57 - $2,686	23%
Aetna	$68 - $2,629	28%
Moda Health Plan - All Plans	$69 - $1,329	28%
Sterling Life - All Plans	$70 - $1,382	29%
Medicare (plans)	$71 - $1,329	29%
Devoted Health	$73 - $1,435	30%
Blue Cross Blue Shield	$78 - $2,459	32%
Hvhs Mcare - All Plans	$82 - $1,342	34%
Pacificsource - All Plans	$150 - $2,714	62%
Ods Health Plan - All Other Plans	$158 - $2,742	65%
Lifewise - All Plans	$438 - $2,550	180%
Ah Employee Health Plan - All Plans	$457 - $2,657	187%
First Choice Health- All Plans	$457 - $2,657	187%
Health Net - All Plans	$457 - $2,657	187%
Providence Preferred - All Plans	$476 - $2,770	195%
Workers Comp	$486 - $2,827	199%
Cigna	$2,542 - $2,686	1043%
Phcs Preferred - All Plans	$2,542 - $2,686	1043%

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 $1,445.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 72148.

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 72148.
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.