CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Adventist Health Tillamook

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77067
Insurance Median: $295
Cash Discount Price: $191
vs. Medicare Baseline: 2.34x Medicare

The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Adventist Health Tillamook is $295. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $191. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 2.34x the Medicare baseline. Located in 1000 Third Street, Tillamook, OR.

Cash / Self-Pay

$191

Average discount available for prompt cash payment at this facility.

Insurance Median

$295

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$126.25

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $126.25 (100%)

Cash / Self-Pay: $191 (151%)

Insurance Median: $295 (234%)

Cash: $191 (151% of Medicare)

Ins. Median: $295 (234% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $126.25 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 234% of the Medicare baseline (a markup of 134%). 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	$35 - $445	28%
Moda Health Plan - All Plans	$35 - $225	28%
Medicare (plans)	$36 - $225	29%
Sterling Life - All Plans	$36 - $234	29%
Devoted Health	$37 - $243	29%
UnitedHealthcare	$38 - $454	30%
Blue Cross Blue Shield	$40 - $416	32%
Hvhs Mcare - All Plans	$42 - $227	33%
Pacificsource - All Plans	$48 - $459	38%
Ods Health Plan - All Other Plans	$82 - $464	65%
Lifewise - All Plans	$118 - $431	93%
Ah Employee Health Plan - All Plans	$123 - $449	97%
First Choice Health- All Plans	$123 - $449	97%
Health Net - All Plans	$123 - $449	97%
Providence Preferred - All Plans	$128 - $468	101%
Workers Comp	$131 - $478	104%
Cigna	$330 - $454	261%
Phcs Preferred - All Plans	$330 - $454	261%

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 $191.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 77067.

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 77067.
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.