NORTHWEST MEDICAL FOUNDATION OF TILLAMOOK
1000 3rd St, Tillamook, OR · Adventisthealth · · NPI 1871575225
Published prices by procedure
Cash price is what you pay without insurance. The negotiated range spans the lowest to highest rate this hospital agreed with insurers.
| Procedure | Cash price | Gross charge | Negotiated range | Payers |
|---|---|---|---|---|
| 1st hosp/birthing center care per day nml nb 99460 CPT 99460 | $131.22 | $243.00 | $79.59 – $202.50 | 11 |
| 3d recon without postprocess indpndt CPT 76376 | $35.10 | $65.00 | $9.24 – $21.60 | 11 |
| 99381 initial comp preventive med less than 1 year new CPT 99381 | $142.02 | $263.00 | $99.45 – $319.03 | 9 |
| 99382 initial comp preventive med 1 to 4 years new CPT 99382 | $154.44 | $286.00 | $113.10 – $319.03 | 9 |
| 99383 initial comp preventive med 5 to 11 years new CPT 99383 | $153.36 | $284.00 | $113.10 – $319.03 | 9 |
| 99391 periodic comp preventive med less than 1 year est CPT 99391 | $117.72 | $218.00 | $85.15 – $319.03 | 9 |
| 99392 periodic comp preventive med 1 to 4 years est CPT 99392 | $132.30 | $245.00 | $99.45 – $319.03 | 9 |
| 99393 periodic comp preventive med 5 to 11 years est CPT 99393 | $131.22 | $243.00 | $99.45 – $319.03 | 9 |
| 99394 periodic comp preventive med 12 to 17 years est CPT 99394 | $144.18 | $267.00 | $113.10 – $319.03 | 9 |
| 99397 periodic comp preventive med 65+ years est CPT 99397 | $177.12 | $328.00 | $143.00 – $319.03 | 9 |
| Abatacept (with maltose) 250 mg intravenous solution HCPCS J0129 | $2,008.80 | $3,720.00 | $42.00 – $42.00 | 1 |
| Abd exp/postop hem/throm/infec 35840 CPT 35840 | $2,475.36 | $4,584.00 | $1,059.50 – $2,614.50 | 11 |
| Abdominal CT scan (with and without contrast) CPT 74170 | $246.24 | $456.00 | $53.86 – $149.25 | 11 |
| Abdominal CT scan (with contrast) CPT 74160 | $224.64 | $416.00 | $49.05 – $135.75 | 11 |
| Abdominal CT scan (without contrast) CPT 74150 | $210.06 | $389.00 | $45.93 – $126.75 | 11 |
| Abdominal MRI (with and without contrast) CPT 74183 | $387.72 | $718.00 | $85.13 – $232.50 | 11 |
| Abdominal MRI (with contrast) CPT 74182 | $305.64 | $566.00 | $66.46 – $184.50 | 11 |
| Abdominal MRI (without contrast) CPT 74181 | $258.66 | $479.00 | $55.85 – $156.00 | 11 |
| Abdominal paracentesis w/image guidance CPT 49083 | $332.10 | $615.00 | $48.00 – $233.25 | 11 |
| Abdominal Ultrasound (complete) CPT 76700 | $142.56 | $264.00 | $36.97 – $87.00 | 11 |
| Abdominal Ultrasound (limited) CPT 76705 | $104.76 | $194.00 | $27.06 – $62.25 | 11 |
| Abd paracentesis/w/o image guide 49082 CPT 49082 | $373.14 | $691.00 | $48.00 – $160.50 | 11 |
| Ablate inf turbinate submuc 30802 CPT 30802 | $421.20 | $780.00 | $180.07 – $418.50 | 11 |
| Ablation of upper extremity nerves rf CPT 64999 | $121.50 | $225.00 | $47.00 – $51.00 | 3 |
| Abscess drain retroperitoneal surg code CPT 49406 | $608.04 | $1,126.00 | $48.00 – $427.50 | 11 |
| Acetaminophen 10 mg/ml soln 100 ml glass cont HCPCS J0131 | $25.98 | $48.10 | $48.10 – $48.10 | 1 |
| Acetylcysteine 200 mg/ml (20 %) intravenous solution HCPCS J0132 | $115.17 | $213.28 | $213.28 – $213.28 | 1 |
| Acne surgery 10040 CPT 10040 | $244.08 | $452.00 | $41.59 – $157.68 | 11 |
| Aco annual medicare visit (awv), initial g0438aco HCPCS G0438 | $231.93 | $429.50 | $298.49 – $319.03 | 6 |
| Aco annual medicare visit (awv), subsq g0439aco HCPCS G0439 | $172.26 | $319.00 | $48.00 – $298.49 | 10 |
| Aco depression screen annual medicare g0444aco HCPCS G0444 | $25.38 | $47.00 | $298.49 – $319.03 | 6 |
| Acoustic refl threshold tst CPT 92568 | $32.13 | $59.50 | $12.58 – $36.00 | 11 |
| Acromp/acromionectomy prtl CPT 23130 | $922.86 | $1,709.00 | $573.95 – $1,326.00 | 11 |
| Acyclovir 400 mg tablet HCPCS J8499 | $38.86 | $71.97 | $71.97 – $71.97 | 1 |
| Adenosine 3 mg/250 ml bag for osm HCPCS J0153 | $21.06 | $39.00 | $39.00 – $39.00 | 1 |
| Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution HCPCS J1815 | $14.90 | $27.59 | $2.00 – $2.00 | 1 |
| Administration immunization 1 vaccine CPT 90471 | $37.26 | $69.00 | $21.88 – $51.00 | 11 |
| Administration immunization each additional vaccine CPT 90472 | $25.38 | $47.00 | $15.84 – $51.00 | 11 |
| Administration immunization intranasal/oral route 1 vaccine CPT 90473 | $27.00 | $50.00 | $16.56 – $51.00 | 11 |
| Administration immunization intranasal/oral route each additional vaccine CPT 90474 | $16.74 | $31.00 | $12.23 – $51.00 | 11 |
| Administration rsv monoclonal ab seasonal dose im w/counseling CPT 96380 | $33.48 | $62.00 | $29.78 – $63.11 | 9 |
| Administration vaccine hepatitis b HCPCS G0010 | $25.38 | $47.00 | $47.00 – $51.00 | 3 |
| Administration vaccine rsv monoclonal ab seasonal dose im CPT 96381 | $28.62 | $53.00 | $24.21 – $51.30 | 9 |
| Ado-trastuzumab emtansine 100 mg intravenous solution HCPCS J9354 | $16.20 | $30.00 | $30.00 – $30.00 | 1 |
| Air conduction bilat CPT 92552 | $65.34 | $121.00 | $33.15 – $85.10 | 11 |
| Albumin (human), 25%, 50ml HCPCS P9047 | $314.93 | $583.20 | $206.00 – $206.00 | 1 |
| Albumin (human), 5%, 250 ml HCPCS P9045 | $219.09 | $405.72 | $405.72 – $405.72 | 1 |
| Albuterol ipratrop non-comp HCPCS J7620 | $0.57 | $1.06 | $1.06 – $51.00 | 6 |
| Albuterol non-comp unit HCPCS J7613 | $0.57 | $1.06 | $0.04 – $48.00 | 6 |
| Allergy injections; 2 or more 95117 CPT 95117 | $21.60 | $40.00 | $12.21 – $26.00 | 11 |
| Allergy injection; single 95115 CPT 95115 | $18.36 | $34.00 | $10.21 – $21.64 | 11 |
| Allograft amniotic activebarrier 200 2x2cm-q4100-cost per sheet HCPCS Q4100 | $7,938.00 | $14,700.00 | $14,700.00 – $14,700.00 | 1 |
| Allograft graftjacket 2x12cm-q4107-cost per sq cm HCPCS Q4107 | $4,069.44 | $7,536.00 | $7,536.00 – $7,536.00 | 1 |
| Allograft umbil cord+amniotic membrane-q4148-cost per sq cm HCPCS Q4148 | $7,970.40 | $14,760.00 | $3,513.00 – $3,513.00 | 1 |
| Allograft umbilical epicord 15 sq cm-q4187-cost per sq cm HCPCS Q4187 | $6,889.32 | $12,758.00 | $12,758.00 – $12,758.00 | 1 |
| Alteplase 100 mg infusion from pyxis vial HCPCS J2997 | $323.97 | $599.95 | $88.00 – $88.00 | 1 |
| Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV HCPCS J0283 | $103.15 | $191.02 | $147.78 – $147.78 | 1 |
| Amniocentesisdiagnostic 59000 CPT 59000 | $184.95 | $342.50 | $68.68 – $174.75 | 11 |
| Amp f/th 1/2 jt/phalanx w/neurect local flap CPT 26952 | $1,443.42 | $2,673.00 | $653.82 – $1,418.25 | 11 |
| Ampicillin 1 gram solution for injection HCPCS J0290 | $32.11 | $59.47 | $39.44 – $39.44 | 1 |
| Ampicillin-sulbactam 1.5 gram solution for injection HCPCS J0295 | $24.38 | $45.14 | $45.14 – $45.14 | 1 |
| Amp metatarsal w/toe single 28810 CPT 28810 | $936.90 | $1,735.00 | $386.68 – $927.75 | 11 |
| Amputate thigh through femur 27590 CPT 27590 | $1,589.22 | $2,943.00 | $687.99 – $1,726.50 | 11 |
| Amputation leg thr tib/fib 27880 CPT 27880 | $2,057.67 | $3,810.50 | $785.46 – $1,976.25 | 11 |
| Amputation leg; tib/fib f/u 27886 CPT 27886 | $1,333.80 | $2,470.00 | $577.69 – $1,422.00 | 11 |
| Amputation of lower leg CPT 27882 | $1,326.51 | $2,456.50 | $528.23 – $1,298.25 | 11 |
| Amputation of midtarsal 28800 CPT 28800 | $1,114.02 | $2,063.00 | $480.52 – $1,156.50 | 11 |
| Amputation thru metatarsal CPT 28805 | $1,615.68 | $2,992.00 | $633.10 – $1,564.50 | 11 |
| Amputation toe interphalangeal joint CPT 28825 | $604.80 | $1,120.00 | $152.32 – $795.00 | 11 |
| Amputation toe metatarsophalangeal joint CPT 28820 | $1,071.09 | $1,983.50 | $157.36 – $848.25 | 11 |
| Analyze neurostimulator simple w/reprogramming 95971 CPT 95971 | $71.28 | $132.00 | $33.68 – $87.75 | 11 |
| An fluoro guide for cvp CPT 77001 | $65.34 | $121.00 | $17.29 – $39.75 | 9 |
| Angiotensin ii 0.5 mg/ml soln 1 ml vial HCPCS J3490 | $4,188.02 | $7,755.60 | $4.24 – $51.00 | 6 |
| Ankle X-ray CPT 73610 | $205.74 | $381.00 | $8.24 – $18.75 | 11 |
| Annual Physical, Established Patient (age 18-39) CPT 99395 | $144.18 | $267.00 | $113.10 – $319.03 | 9 |
| Annual Physical, Established Patient (age 40-64) CPT 99396 | $158.76 | $294.00 | $128.05 – $319.03 | 9 |
| Annual Physical, New Patient (age 18-39) CPT 99385 | $165.78 | $307.00 | $128.05 – $319.03 | 9 |
| Annual Physical, New Patient (age 40-64) CPT 99386 | $194.40 | $360.00 | $156.65 – $319.03 | 9 |
| Anoscopy and biopsy CPT 46606 | $403.92 | $748.00 | $69.06 – $162.75 | 11 |
| Anoscopy and dilation 46604 CPT 46604 | $231.39 | $428.50 | $60.58 – $141.75 | 11 |
| Anoscopy control bleeding 46614 CPT 46614 | $135.00 | $250.00 | $59.78 – $185.25 | 11 |
| Anoscopy remove fb 46608 CPT 46608 | $173.88 | $322.00 | $77.92 – $183.00 | 11 |
| Ant colporrhaphy/rpr cyctocele 57240 CPT 57240 | $1,427.49 | $2,643.50 | $528.48 – $1,311.75 | 11 |
| Anticoag mgmt pt warfarin CPT 93793 | $17.82 | $33.00 | $298.49 – $319.03 | 6 |
| Ant/post colporrhap/enterocele rpr 57265 CPT 57265 | $2,227.50 | $4,125.00 | $742.83 – $1,888.50 | 11 |
| Appendectomy CPT 44950 | $1,361.61 | $2,521.50 | $578.97 – $1,404.75 | 11 |
| Appendectomy add-on 44955 CPT 44955 | $177.12 | $328.00 | $71.19 – $182.25 | 11 |
| Appendectomy/open/rup/w/absc/peri 44960 CPT 44960 | $1,853.28 | $3,432.00 | $787.58 – $1,917.00 | 11 |
| Appendix Removal (Laparoscopic) CPT 44970 | $1,265.49 | $2,343.50 | $553.80 – $1,311.75 | 11 |
| App high cost ss f/n/g/h/f <100sq cm addl <25sq cm CPT 15276 | $51.30 | $95.00 | $21.34 – $56.25 | 11 |
| Application finger splntstatic 29130 CPT 29130 | $90.18 | $167.00 | $24.90 – $63.75 | 11 |
| Application long leg splint 29505 CPT 29505 | $197.10 | $365.00 | $53.38 – $113.12 | 11 |
| Application lower leg splint 29515 CPT 29515 | $157.14 | $291.00 | $48.49 – $106.50 | 11 |
| Application of forearm cast 29075 CPT 29075 | $191.16 | $354.00 | $57.28 – $132.00 | 11 |
| Application of long arm cast 29065 CPT 29065 | $210.06 | $389.00 | $62.66 – $146.25 | 11 |
| Application of long leg cast 29345 CPT 29345 | $291.60 | $540.00 | $298.49 – $319.03 | 6 |
| Application of paste boot 29580 CPT 29580 | $198.72 | $368.00 | $22.67 – $69.12 | 11 |
| Application short leg cast 29405 CPT 29405 | $124.20 | $230.00 | $54.39 – $126.75 | 11 |
| Application skin substitute graft face/scalp/neck/genit/hnd/ft <100 sq cm 1st 25 sq cm CPT 15275 | $208.98 | $387.00 | $48.00 – $206.25 | 11 |
| Appl mltpln uni ext fixj sys CPT 20692 | $2,378.16 | $4,404.00 | $679.90 – $2,421.00 | 11 |
A missing value means the hospital did not publish that price — it never means the price is zero. Real bills can add facility fees, supplies and professional fees; see our methodology.