CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Adventist Health Tillamook

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99203
  • Insurance Median: $203
  • Cash Discount Price: $126
  • vs. Medicare Baseline: 1.73x Medicare
The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Adventist Health Tillamook is $203. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $126. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 1.73x the Medicare baseline. Located in 1000 Third Street, Tillamook, OR.
Cash / Self-Pay
$126

Average discount available for prompt cash payment at this facility.

Insurance Median
$203

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$117.57

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $117.57 (100%)
Cash / Self-Pay: $126 (107%)
Insurance Median: $203 (173%)
Cash: $126 (107% of Medicare)
Ins. Median: $203 (173% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $117.57 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.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Devoted Health $63 - $319 54%
Medicare (plans) $85 - $298 72%
Moda Health Plan - All Plans $85 - $298 72%
Hvhs Mcare - All Plans $113 - $301 96%
Aetna $115 - $277 98%
Blue Cross Blue Shield $120 - $298 102%
Lifewise - All Plans $127 - $269 108%
Ah Employee Health Plan - All Plans $133 - $280 113%
First Choice Health- All Plans $133 - $280 113%
Health Net - All Plans $133 - $280 113%
Pacificsource - All Plans $136 - $286 116%
Providence Preferred - All Plans $138 - $292 117%
Workers Comp $141 - $298 120%
UnitedHealthcare $148 126%
Ods Health Plan - All Other Plans $160 - $289 136%
Cigna $283 241%
Phcs Preferred - All Plans $283 241%
Sterling Life - All Plans $310 264%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1000 Third Street, Tillamook, OR 97141
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Critical Access Hospitals