Aco annual medicare visit (awv), initial g0438aco at NORTHWEST MEDICAL FOUNDATION OF TILLAMOOK

1000 3rd St, Tillamook, OR · Adventisthealth · · NPI 1871575225

Source: hospital's published price file ↗ · Published May 22, 2026 · Ingested Sep 16, 2026

$231.93

Cash price

?

Discounted cash price

What a hospital charges a self-pay patient who pays directly, without going through insurance — usually well below the gross charge.

Example: A CT scan has a $3,200 gross charge but an $850 discounted cash price. Ask for it by name when scheduling — hospitals don't always advertise it up front.

Full explanation →

What you pay up front if you don't use insurance.

$429.50

Gross charge

?

Gross charge (chargemaster price)

The hospital's full, undiscounted list price — pulled from its internal "chargemaster" price list. Almost no one actually pays this.

Example: A chest X-ray has a gross charge of $1,450. The same hospital's discounted cash price for the same X-ray is $180 — the gross charge mostly anchors negotiations, not what patients pay.

Full explanation →

The hospital's undiscounted list price — almost no one pays this.

$224.11 with AETNA MCARE vs $429.50 with WORKERS COMP — same scan, same building. Share

Negotiated rates by payer
?

Negotiated rate

The price a specific insurance plan agreed to pay the hospital for a service — it varies by insurer, and even by plan within the same insurer.

Example: The same knee MRI has a negotiated rate of $904 with one insurer's PPO plan and $1,509 with another's — identical hospital, identical scan.

Full explanation →

Payer
?

Payer

The insurance company footing the bill — Aetna, UnitedHealthcare, Medicare, and so on.

Example: "Blue Cross Blue Shield" is the payer. Its negotiated rate for an MRI might be $904, while a different payer's negotiated rate for the same scan is $1,509.

Full explanation →
Plan
?

Plan

The specific product an insurer sells — e.g. "Blue Cross PPO 500" — which sets your deductible, coinsurance and negotiated rates.

Example: Two people both insured by Aetna can owe very different amounts for the same MRI: $50 with an HMO plan's flat copay, or the full $1,200 toward a high-deductible PPO plan's unmet deductible.

Full explanation →
Negotiated rate vs. cash
AETNA MCARE AETNA MCARE $224.11 ↓ -3%
REGENCE BCBS MCARE REGENCE BCBS MCARE $298.49 ↑ +29%
ODS HEALTH MEDICARE ODS HEALTH MEDICARE $298.49 ↑ +29%
MODA HEALTH PLAN - ALL PLANS MODA HEALTH PLAN - ALL PLANS $298.49 ↑ +29%
HVHS MCARE - ALL PLANS HVHS MCARE - ALL PLANS $301.47 ↑ +30%
STERLING LIFE - ALL PLANS STERLING LIFE - ALL PLANS $310.43 ↑ +34%
DEVOTED HEALTH DEVOTED HEALTH $319.03 ↑ +38%
REGENCE BCBS PREFERRED REGENCE BCBS PREFERRED $365.08 ↑ +57%
REGENCE BCBS - ALL OTHER PLANS REGENCE BCBS - ALL OTHER PLANS $373.67 ↑ +61%
LIFEWISE - ALL PLANS LIFEWISE - ALL PLANS $387.41 ↑ +67%
AETNA- ALL OTHER PLANS AETNA- ALL OTHER PLANS $399.44 ↑ +72%
AH EMPLOYEE HEALTH PLAN - ALL PLANS AH EMPLOYEE HEALTH PLAN - ALL PLANS $403.73 ↑ +74%
HEALTH NET - ALL PLANS HEALTH NET - ALL PLANS $403.73 ↑ +74%
FIRST CHOICE HEALTH- ALL PLANS FIRST CHOICE HEALTH- ALL PLANS $403.73 ↑ +74%
CIGNA - ALL PLANS CIGNA - ALL PLANS $408.03 ↑ +76%
PHCS PREFERRED - ALL PLANS PHCS PREFERRED - ALL PLANS $408.03 ↑ +76%
PACIFICSOURCE - ALL PLANS PACIFICSOURCE - ALL PLANS $412.32 ↑ +78%
ODS HEALTH PLAN - ALL OTHER PLANS ODS HEALTH PLAN - ALL OTHER PLANS $416.62 ↑ +80%
PROVIDENCE PREFERRED - ALL PLANS PROVIDENCE PREFERRED - ALL PLANS $420.91 ↑ +81%
WORKERS COMP WORKERS COMP $429.50 ↑ +85%

Visitor-reported prices

visitor-reported
Report what you paid sign in to post

Comments

Add a comment sign in to post

Aco annual medicare visit (awv), initial g0438aco at other Oregon hospitals

Hospital City Cash price Negotiated range
Providence Hood River Memorial Hospital Hood River $476.25 not published
Providence Seaside Hospital Seaside $476.25 not published
MID-COLUMBIA MEDICAL CENTER The Dalles $212.64 $58.00 – $443.00
Providence Medford Medical Center Medford not published $146.70 – $366.74
Providence Newberg Medical Center Newberg not published $180.44 – $335.57
Providence Willamette Falls Medical Center Oregon City not published $180.44 – $366.74
Providence Milwaukie Hospital Milwaukie not published $180.44 – $366.74
Providence Portland Medical Center Portland not published $180.44 – $366.74

All Oregon hospitals for this procedure →