CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Northwest Medical Center

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90791
  • Insurance Median: $196
  • Cash Discount Price: $275
  • vs. Medicare Baseline: 1.08x Medicare
The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Northwest Medical Center is $196. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $275. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.08x the Medicare baseline. Located in 6200 North La Cholla Boulevard, Tucson, AZ.
Cash / Self-Pay
$275

Average discount available for prompt cash payment at this facility.

Insurance Median
$196

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$181.34

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $181.34 (100%)
Cash / Self-Pay: $275 (152%)
Insurance Median: $196 (108%)
Cash: $275 (152% of Medicare)
Ins. Median: $196 (108% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $181.34 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.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Medicaid / KanCare $96 - $103 53%
Magellan $101 - $196 56%
Blue Cross Blue Shield $137 - $736 76%
Aetna $165 - $412 91%
Veterans Eval Services $165 91%
Cigna $186 - $275 103%
Humana $186 103%
Medicare (plans) $186 103%
Node Caremore Mcr Adv $186 103%
Scan Health Plan $186 103%
UnitedHealthcare $186 - $458 103%
Pascua Yaqui Tribe $188 104%
Department Of Veterans Affairs $189 104%
Node Non Par Hospice Agree $189 104%
Node Va $189 104%
Tricare $189 104%
Triwest $189 104%
Fresenius Health $190 105%
Node Clover Health Mcr Adv $191 105%
Node Devoted Health Mcr Adv $192 106%
Node Banner Mcr Adv $196 108%
Wellcare $196 108%
Self Pay $220 - $330 121%
Node Us Dept Of Labor $237 131%
Ambetter / Centene $267 147%
Node Health Choice Health Exchange $278 153%
Health Net $300 165%
Node Fusion Network $341 188%
Node J Allen Inmate Health Svcs $360 199%
Seven Corners $436 240%
First Health Coventry $481 265%
Coventry Medical Center $550 303%
Multiplan $760 419%
Prime Health $779 430%
Healthsmart $824 454%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 6200 North La Cholla Boulevard, Tucson, AZ 85741
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals