CMS Price Transparency Data

Urinalysis (automated, with microscopy)

Facility: Adventist Health Tillamook

Billing Code: 81001 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 81001
Insurance Median: $38
Cash Discount Price: $33
vs. Medicare Baseline: 11.99x Medicare

The contracted insurance negotiated median rate for a Urinalysis (automated, with microscopy) at Adventist Health Tillamook is $38. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $33. Compared to the federal Medicare reimbursement reference rate of $3.17, this hospital’s rate is 11.99x the Medicare baseline. Located in 1000 Third Street, Tillamook, OR.

Cash / Self-Pay

$33

Average discount available for prompt cash payment at this facility.

Insurance Median

$38

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$3.17

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $3.17 (100%)

Cash / Self-Pay: $33 (1041%)

Insurance Median: $38 (1199%)

Cash: $33 (1041% of Medicare)

Ins. Median: $38 (1199% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $3.17 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 1199% of the Medicare baseline (a markup of 1099%). 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
Blue Cross Blue Shield	$13 - $70	410%
Hvhs Mcare - All Plans	$13 - $38	410%
Medicare (plans)	$13 - $38	410%
Moda Health Plan - All Plans	$13 - $38	410%
Sterling Life - All Plans	$13 - $39	410%
Aetna	$14 - $74	442%
Devoted Health	$14 - $41	442%
Lifewise - All Plans	$24 - $72	757%
Ah Employee Health Plan - All Plans	$25 - $75	789%
First Choice Health- All Plans	$25 - $75	789%
Health Net - All Plans	$25 - $75	789%
Cigna	$26 - $76	820%
Ods Health Plan - All Other Plans	$26 - $78	820%
Pacificsource - All Plans	$26 - $77	820%
Phcs Preferred - All Plans	$26 - $76	820%
Providence Preferred - All Plans	$26 - $78	820%
UnitedHealthcare	$26 - $76	820%
Workers Comp	$27 - $80	852%

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 $33.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 81001.

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 81001.
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.