CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Adventist Health Tillamook

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 95810
Insurance Median: $2,035
Cash Discount Price: $1,320
vs. Medicare Baseline: 2.32x Medicare

The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Adventist Health Tillamook is $2,035. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,320. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 2.32x the Medicare baseline. Located in 1000 Third Street, Tillamook, OR.

Cash / Self-Pay

$1,320

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,035

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$877.34

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $877.34 (100%)

Cash / Self-Pay: $1,320 (150%)

Insurance Median: $2,035 (232%)

Cash: $1,320 (150% of Medicare)

Ins. Median: $2,035 (232% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $877.34 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 232% of the Medicare baseline (a markup of 132%). 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	$118 - $4,027	13%
Moda Health Plan - All Plans	$121 - $2,035	14%
Sterling Life - All Plans	$123 - $2,116	14%
Medicare (plans)	$124 - $2,035	14%
Devoted Health	$128 - $2,198	15%
Blue Cross Blue Shield	$136 - $3,767	16%
Hvhs Mcare - All Plans	$143 - $2,055	16%
UnitedHealthcare	$251 - $4,114	29%
Ods Health Plan - All Other Plans	$259 - $4,200	30%
Pacificsource - All Plans	$338 - $4,157	39%
Lifewise - All Plans	$504 - $3,906	57%
Ah Employee Health Plan - All Plans	$525 - $4,070	60%
First Choice Health- All Plans	$525 - $4,070	60%
Health Net - All Plans	$525 - $4,070	60%
Providence Preferred - All Plans	$548 - $4,243	62%
Workers Comp	$559 - $4,330	64%
Cigna	$4,114	469%
Phcs Preferred - All Plans	$4,114	469%

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 $1,320.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 95810.

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 95810.
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.