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 |
|---|---|---|---|---|
| Ghs moderate sedation ea addtl 15 min CPT 99153 | $38.88 | $72.00 | $12.11 – $48.00 | 11 |
| Ghs moderate sedation ea addtl 15 min, other CPT 99157 | $128.79 | $238.50 | $48.00 – $135.75 | 11 |
| Ghs nailbed repair/nail removal CPT 11760 | $387.72 | $718.00 | $101.81 – $246.75 | 11 |
| Ghs nerve blk intercostal, ea addtl level CPT 64421 | $54.81 | $101.50 | $21.20 – $168.48 | 11 |
| Ghs nerve blk intercostal, single level CPT 64420 | $150.66 | $279.00 | $51.49 – $129.00 | 11 |
| Ghs nerve block axillary nerve CPT 64417 | $154.44 | $286.00 | $60.11 – $137.52 | 11 |
| Ghs nerve block brachial plexus CPT 64415 | $164.16 | $304.00 | $65.22 – $138.24 | 11 |
| Ghs nerve block interscaline CPT 64510 | $159.84 | $296.00 | $68.61 – $162.00 | 11 |
| Ghs nerve block lumbar or thoracic symp CPT 64520 | $178.20 | $330.00 | $75.52 – $178.50 | 11 |
| Ghs nerve block sciatic nerve CPT 64445 | $185.49 | $343.50 | $64.58 – $150.48 | 11 |
| Ghs ng placement w fluoro guidance CPT 43752 | $125.82 | $233.00 | $33.49 – $88.50 | 11 |
| Ghs optokenetic CPT 92544 | $33.48 | $62.00 | $13.91 – $30.75 | 11 |
| Ghs oscillating trac CPT 92545 | $31.32 | $58.00 | $12.91 – $28.50 | 11 |
| Ghs osteopathic manipulative tx, 1-2 regions CPT 98925 | $49.41 | $91.50 | $19.39 – $51.00 | 11 |
| Ghs osteopathic manipulative tx, 3-4 regions CPT 98926 | $67.23 | $124.50 | $29.31 – $77.25 | 11 |
| Ghs pacing - transcutaneous CPT 92953 | $2.16 | $4.00 | $0.90 – $23.76 | 11 |
| Ghs paravert facet/nerve cerv ea add bil CPT 64492 | $186.84 | $346.00 | $48.00 – $131.25 | 11 |
| Ghs paravert facet/nerve lumb ea add bil CPT 64495 | $160.38 | $297.00 | $44.26 – $113.25 | 11 |
| Ghs path - pap (papanicolau) smear - vagina CPT 88141 | $90.72 | $168.00 | $23.89 – $54.75 | 9 |
| Ghs peritonsillar abscess i andd CPT 42700 | $403.38 | $747.00 | $125.42 – $289.50 | 11 |
| Ghs picc line insert < 5 CPT 36568 | $212.49 | $393.50 | $81.23 – $201.00 | 11 |
| Ghs plngl fx pm cl CPT 26725 | $750.60 | $1,390.00 | $298.49 – $665.61 | 11 |
| Ghs pos nystagmus CPT 92542 | $54.54 | $101.00 | $24.25 – $54.00 | 11 |
| Ghs ppd (tb intradermal) CPT 86580 | $450.63 | $834.50 | $10.88 – $19.50 | 9 |
| Ghs removal intranasal foreign body CPT 30300 | $454.95 | $842.50 | $113.68 – $242.25 | 11 |
| Ghs removal pharyngeal foreign body CPT 42809 | $264.60 | $490.00 | $113.94 – $267.00 | 11 |
| Ghs repair extensor tendon hand, ea tendon CPT 26410 | $1,265.76 | $2,344.00 | $587.96 – $1,245.95 | 11 |
| Ghs simple repair 12.6 - 20.0 cm - 12005 CPT 12005 | $375.84 | $696.00 | $85.54 – $306.00 | 11 |
| Ghs simple repair 12.6 - 20.0 cm - 12016 CPT 12016 | $457.38 | $847.00 | $116.14 – $408.96 | 11 |
| Ghs simple repair 20.1 - 30.0 cm - 12006 CPT 12006 | $304.29 | $563.50 | $104.10 – $386.64 | 11 |
| Ghs simple repair 20.1 - 30.0 cm - 12017 CPT 12017 | $404.46 | $749.00 | $146.48 – $487.44 | 11 |
| Ghs simple repair 5.1 - 7.5 cm - 12014 CPT 12014 | $294.84 | $546.00 | $68.54 – $267.12 | 11 |
| Ghs simple repair 7.6 - 12.5 cm - 12004 CPT 12004 | $289.71 | $536.50 | $68.81 – $245.52 | 11 |
| Ghs simple repair 7.6 - 12.5 cm - 12015 CPT 12015 | $540.27 | $1,000.50 | $85.77 – $334.80 | 11 |
| Ghs simple repair over 30 cm - 12007 CPT 12007 | $368.82 | $683.00 | $127.71 – $443.52 | 11 |
| Ghs simple repair over 30 cm - 12018 CPT 12018 | $459.27 | $850.50 | $165.18 – $605.52 | 11 |
| Ghs spont nystagmus CPT 92541 | $47.52 | $88.00 | $20.25 – $45.00 | 11 |
| Ghs st - eval for alt comm CPT 92567 | $30.78 | $57.00 | $8.58 – $37.05 | 11 |
| Ghs superficial wnd dehiscence simp12020 CPT 12020 | $626.40 | $1,160.00 | $174.12 – $407.25 | 11 |
| Ghs superficial wnd dehis w packing12021 CPT 12021 | $368.82 | $683.00 | $131.08 – $300.75 | 11 |
| Ghs tracheostomy emergency - transtracheal CPT 31603 | $651.78 | $1,207.00 | $267.66 – $697.50 | 11 |
| Ghs tx distal phalangeal fx with manipulation CPT 26755 | $707.94 | $1,311.00 | $291.84 – $618.44 | 11 |
| Ghs vaginal delivery only CPT 59409 | $1,826.28 | $3,382.00 | $681.48 – $1,764.75 | 11 |
| Ghs windowing of cast CPT 29730 | $96.12 | $178.00 | $37.51 – $93.75 | 11 |
| Glucagon hcl 1 mg/ml solution for injection HCPCS J1611 | $442.09 | $818.68 | $818.68 – $818.68 | 1 |
| Glucose blood by monitoring device cleared by fda for home use CPT 82962 | $12.42 | $23.00 | $0.75 – $48.00 | 5 |
| Glycopyrrolate 0.2 mg/ml injection solution HCPCS J1596 | $20.61 | $38.17 | $38.17 – $38.17 | 1 |
| Golimumab 12.5 mg/ml intravenous solution HCPCS J1602 | $2,590.95 | $4,798.06 | $64.00 – $64.00 | 1 |
| Graft apligraf 3in 44sqcm-q4101-cost per sq cm HCPCS Q4101 | $32.40 | $60.00 | $60.00 – $60.00 | 1 |
| Graft axiofill 1000mg HCPCS J3590 | $80.51 | $149.10 | $149.10 – $149.10 | 1 |
| Graft impl ult thck 6x12cm -cost per sq cm HCPCS Q4116 | $6,966.00 | $12,900.00 | $12,900.00 – $12,900.00 | 1 |
| Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm HCPCS Q4133 | $5,540.40 | $10,260.00 | $10,260.00 – $10,260.00 | 1 |
| Granisetron hcl injection HCPCS J1626 | $30.78 | $57.00 | $57.00 – $57.00 | 1 |
| Great toe with reduction 28495 CPT 28495 | $329.40 | $610.00 | $151.96 – $322.02 | 11 |
| Gstrst open wo constj tube CPT 43830 | $1,470.15 | $2,722.50 | $648.52 – $1,533.00 | 11 |
| Guided cath fluid drainage 10030 CPT 10030 | $424.98 | $787.00 | $48.00 – $298.50 | 11 |
| Gynecomastia (males) 19300 CPT 19300 | $2,219.40 | $4,110.00 | $413.01 – $911.25 | 11 |
| Haloperidol decanoate 50 mg/ml intramuscular solution HCPCS J1631 | $69.01 | $127.80 | $127.80 – $127.80 | 1 |
| Haloperidol lactate 5 mg/ml injection solution HCPCS J1630 | $19.95 | $36.95 | $36.95 – $36.95 | 1 |
| Hand X-ray CPT 73130 | $205.74 | $381.00 | $8.57 – $18.75 | 11 |
| Hc nm kidney imaging with flow CPT 78701 | $86.40 | $160.00 | $19.31 – $51.00 | 11 |
| Head CT scan (with and without contrast) CPT 70470 | $224.64 | $416.00 | $49.05 – $135.00 | 11 |
| Head CT scan (with contrast) CPT 70460 | $199.80 | $370.00 | $43.66 – $120.00 | 11 |
| Head CT scan (without contrast) CPT 70450 | $150.12 | $278.00 | $33.05 – $90.75 | 11 |
| Hemin 350 mg intravenous powder for solution HCPCS J1640 | $12.96 | $24.00 | $24.00 – $24.00 | 1 |
| Hemoglobin CPT 85018 | $9.18 | $17.00 | $0.40 – $48.00 | 5 |
| Hemorrhoidectomy intrnl lig rbbr band ligations CPT 46221 | $621.27 | $1,150.50 | $193.06 – $414.00 | 11 |
| Hepagam b im injection HCPCS J1571 | $339.16 | $628.07 | $628.07 – $628.07 | 1 |
| Heparin bolus from bag HCPCS J1644 | $29.86 | $55.30 | $12.00 – $12.00 | 1 |
| Heparin, porcine (pf) 10 unit/ml flush (wrapper) HCPCS J1642 | $21.06 | $39.00 | $7.42 – $7.42 | 1 |
| Hepatobiliary system imaging CPT 78226 | $128.52 | $238.00 | $28.31 – $77.25 | 11 |
| Hernia Repair (Inguinal) CPT 49505 | $2,187.00 | $4,050.00 | $486.97 – $1,137.75 | 11 |
| Hip X-ray CPT 73502 | $174.42 | $323.00 | $10.58 – $48.00 | 11 |
| Home/res vst est mod mdm 40 CPT 99349 | $181.98 | $337.00 | $130.50 – $276.54 | 11 |
| Home/res vst est sf mdm 20 CPT 99347 | $74.52 | $138.00 | $45.64 – $115.50 | 11 |
| Home/res vst new low mdm 30 CPT 99342 | $112.86 | $209.00 | $78.05 – $165.75 | 11 |
| Home/res vst new sf mdm 15 CPT 99341 | $76.41 | $141.50 | $48.65 – $115.50 | 11 |
| Home visit est patient 99348 CPT 99348 | $112.05 | $207.50 | $78.03 – $177.75 | 11 |
| Hydralazine 20 mg/ml injection solution HCPCS J0360 | $39.44 | $73.03 | $73.03 – $73.03 | 1 |
| Hydration IV infusion each additional hour CPT 96361 | $23.22 | $43.00 | $12.89 – $33.12 | 11 |
| Hydration IV infusion initial 31minutes - 1 hour CPT 96360 | $85.05 | $157.50 | $33.19 – $113.04 | 11 |
| Hydrocortisone in ns IV syringe 1 mg/ml (neo/ped) - cnr HCPCS J1720 | $55.32 | $102.44 | $102.44 – $102.44 | 1 |
| Hydromorphone 0.2 mg/ml in 0.9% nacl IV pca opioid naive - 4 hr dose limit (wrapper) HCPCS J1171 | $27.00 | $50.00 | $49.15 – $49.15 | 1 |
| Hydromorphone 20-0.9 mg/100ml-% soln 100 ml cartridge HCPCS J7999 | $37.76 | $69.93 | $37.26 – $37.26 | 1 |
| Hydroxyzine hcl 50 mg/ml intramuscular solution HCPCS J3410 | $18.36 | $34.00 | $1.59 – $48.00 | 6 |
| Hysterosalpingography s&i CPT 74740 | $67.50 | $125.00 | $17.49 – $40.50 | 11 |
| Hysteroscopy ablation CPT 58563 | $711.99 | $1,318.50 | $209.19 – $663.12 | 11 |
| Hysteroscopy biopsy CPT 58558 | $2,622.24 | $4,856.00 | $197.09 – $515.52 | 11 |
| Hysteroscopy dx sep proc CPT 58555 | $408.78 | $757.00 | $130.01 – $365.76 | 11 |
| Hysteroscopy remove fb CPT 58562 | $946.89 | $1,753.50 | $188.15 – $562.32 | 11 |
| Hzv zoster vacc recombinant adjuvanted im inj CPT 90750 | $103.41 | $191.50 | $47.00 – $195.60 | 5 |
| Ibandronate 3 mg/3 ml intravenous syringe HCPCS J1740 | $294.30 | $545.00 | $545.00 – $545.00 | 1 |
| Icatibant injection HCPCS J1744 | $321.84 | $596.00 | $596.00 – $596.00 | 1 |
| I&d frarm&/wrst deep absc/hematoma CPT 25028 | $1,446.66 | $2,679.00 | $298.49 – $1,431.54 | 11 |
| I&d intramural/intramuscular/submuc abscess transanal anes CPT 46045 | $923.40 | $1,710.00 | $434.31 – $949.50 | 11 |
| I&d upper arm/elbow deep abscess/hematoma CPT 23930 | $810.27 | $1,500.50 | $198.68 – $459.00 | 11 |
| I&d vag hemtma obst/postpart CPT 57022 | $378.00 | $700.00 | $154.87 – $382.50 | 11 |
| Ihc/icc per specimen each additional single antibody stain CPT 88341 | $99.36 | $184.00 | $26.59 – $61.50 | 9 |
| Ihc/icc per specimen each multiplex antibody stain CPT 88344 | $136.08 | $252.00 | $35.93 – $83.25 | 9 |
| Ihc/icc per specimen initial single antibody stain CPT 88342 | $181.98 | $337.00 | $32.59 – $82.08 | 9 |
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.