CMS Price Transparency Data

X-ray, lower back

Facility: Adventist Health Tillamook

Billing Code: 72110 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72110
Insurance Median: $251
Cash Discount Price: $170
vs. Medicare Baseline: 2.35x Medicare

The contracted insurance negotiated median rate for a X-ray, lower back at Adventist Health Tillamook is $251. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $170. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.35x the Medicare baseline. Located in 1000 Third Street, Tillamook, OR.

Cash / Self-Pay

$170

Average discount available for prompt cash payment at this facility.

Insurance Median

$251

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$106.81

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $106.81 (100%)

Cash / Self-Pay: $170 (159%)

Insurance Median: $251 (235%)

Cash: $170 (159% of Medicare)

Ins. Median: $251 (235% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $106.81 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 235% of the Medicare baseline (a markup of 135%). 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	$12 - $810	11%
UnitedHealthcare	$12 - $827	11%
Devoted Health	$13 - $442	12%
Medicare (plans)	$13 - $409	12%
Moda Health Plan - All Plans	$13 - $409	12%
Sterling Life - All Plans	$13 - $426	12%
Blue Cross Blue Shield	$14 - $758	13%
Hvhs Mcare - All Plans	$15 - $413	14%
Ods Health Plan - All Other Plans	$28 - $845	26%
Pacificsource - All Plans	$31 - $836	29%
Lifewise - All Plans	$78 - $786	73%
Ah Employee Health Plan - All Plans	$81 - $819	76%
First Choice Health- All Plans	$81 - $819	76%
Health Net - All Plans	$81 - $819	76%
Providence Preferred - All Plans	$84 - $854	79%
Workers Comp	$86 - $871	81%
Cigna	$203 - $827	190%
Phcs Preferred - All Plans	$203 - $827	190%

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 $170.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 72110.

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 72110.
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.