CMS Price Transparency Data

Vaginal delivery (full package)

Facility: Adventist Health Tillamook

Billing Code: 59400 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 59400
Insurance Median: $4,466
Cash Discount Price: $4,932
vs. Medicare Baseline: 2.02x Medicare

The contracted insurance negotiated median rate for a Vaginal delivery (full package) at Adventist Health Tillamook is $4,466. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,932. Compared to the federal Medicare reimbursement reference rate of $2,214.42, this hospital’s rate is 2.02x the Medicare baseline. Located in 1000 Third Street, Tillamook, OR.

Cash / Self-Pay

$4,932

Average discount available for prompt cash payment at this facility.

Insurance Median

$4,466

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$2,214.42

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $2,214.42 (100%)

Cash / Self-Pay: $4,932 (223%)

Insurance Median: $4,466 (202%)

Cash: $4,932 (223% of Medicare)

Ins. Median: $4,466 (202% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $2,214.42 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 202% of the Medicare baseline (a markup of 102%). 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	$2,107 - $2,903	95%
Moda Health Plan - All Plans	$2,150	97%
Sterling Life - All Plans	$2,192	99%
Medicare (plans)	$2,213	100%
Devoted Health	$2,276	103%
Blue Cross Blue Shield	$2,424 - $7,946	109%
Hvhs Mcare - All Plans	$2,550	115%
Pacificsource - All Plans	$3,385	153%
UnitedHealthcare	$4,466	202%
Ods Health Plan - All Other Plans	$4,615	208%
Lifewise - All Plans	$8,238	372%
Ah Employee Health Plan - All Plans	$8,585	388%
First Choice Health- All Plans	$8,585	388%
Health Net - All Plans	$8,585	388%
Providence Preferred - All Plans	$8,950	404%
Workers Comp	$9,133	412%

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 $4,932.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 59400.

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 59400.
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.