CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Northwest Medical Center Sahuarita

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90791
  • Insurance Median: $189
  • Cash Discount Price: $261
  • vs. Medicare Baseline: 1.04x Medicare
The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Northwest Medical Center Sahuarita is $189. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $261. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.04x the Medicare baseline. Located in 16260 South Rancho Sahuarita Boulevard, Sahuarita, AZ.
Cash / Self-Pay
$261

Average discount available for prompt cash payment at this facility.

Insurance Median
$189

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: $261 (144%)
Insurance Median: $189 (104%)
Cash: $261 (144% of Medicare)
Ins. Median: $189 (104% 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%
Mercy Care $96 - $186 53%
Blue Cross Blue Shield $123 - $736 68%
Self Pay $165 - $357 91%
Aetna $186 - $307 103%
Cigna $186 - $275 103%
Humana $186 103%
Medicare (plans) $186 103%
Node Caremore Mcr Adv $186 103%
Node Mercy Care Mcr Adv $186 103%
UnitedHealthcare $186 - $396 103%
Department Of Veterans Affairs $189 104%
Node Champva $189 104%
Node Non Par Hospice Agree $189 104%
Node Triwest $189 - $203 104%
Node Va $189 104%
Tricare $189 104%
Node Clover Health Mcr Adv $191 105%
Node Devoted Health Mcr Adv $192 106%
Banner Mcr Adv $196 108%
Node Banner Mcr Adv $196 108%
Node Wellcare Mcr Adv $196 108%
Node Us Dept Of Labor $237 131%
Ambetter / Centene $267 147%
Node Health Choice Health Exchange $282 156%
Node Fusion Network $341 188%
Node J Allen Inmate Health Svcs $360 199%
Coventry Work Comp Al $550 303%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 16260 South Rancho Sahuarita Boulevard, Sahuarita, AZ 85629
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals