CMS Price Transparency Data
Psychiatric evaluation (first visit)
Facility: Mercyone Waterloo Medical Center
Billing Code: 90791 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 90791
- Insurance Median: $150
- Cash Discount Price: $467
- vs. Medicare Baseline: 0.83x Medicare
The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Mercyone Waterloo Medical Center is $150. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $467. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 0.83x the Medicare baseline. Located in 3421 West Ninth Street, Waterloo, IA.
Cash / Self-Pay
$467
Average discount available for prompt cash payment at this facility.
Insurance Median
$150
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: $467 (258%)
Insurance Median: $150 (83%)
Cash: $467 (258% of Medicare)
Ins. Median: $150 (83% 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
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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 | $79 - $219 | 44% |
| Aetna | $100 - $766 | 55% |
| Align Senior Care | $100 | 55% |
| Ally Align Care Adv | $100 | 55% |
| American Health Advantage Of Idaho | $100 | 55% |
| Aurora Special Needs | $100 | 55% |
| Blue Care Network Advantage | $100 | 55% |
| Blue Cross Blue Shield | $100 - $181 | 55% |
| Blue Shield - De (Highmark) Medciare Advantage | $100 | 55% |
| Care Dimensions | $100 | 55% |
| Care Improvement Plus | $100 | 55% |
| Care Resources Pace | $100 | 55% |
| Careplus Health Plans | $100 | 55% |
| Cca - Zing Health | $100 | 55% |
| Cca Senior Care Options | $100 | 55% |
| Central Valley Medical Services Corp Pace | $100 | 55% |
| Champion Health Plan Mcr Advantage | $100 | 55% |
| Cigna | $100 - $609 | 55% |
| Clear Spring Health | $100 | 55% |
| Clover Health | $100 | 55% |
| Commonwealth Care Alliance | $100 | 55% |
| Community Pace At Home | $100 | 55% |
| Eddy Senior Care-Pace | $100 | 55% |
| Eddy Seniorcare Pace | $100 | 55% |
| Elementcare | $100 | 55% |
| Evercare | $100 | 55% |
| Everence | $100 | 55% |
| Gateway Health Plan | $100 | 55% |
| Genesys Pace Of Genesee County | $100 | 55% |
| Georgia Health Advantage | $100 | 55% |
| Gold Advantage | $100 | 55% |
| Gpa Croell Redi Mix | $100 | 55% |
| Health America Advantra | $100 | 55% |
| Highmark Health Options Dual Plan | $100 | 55% |
| Hope Select Pace | $100 | 55% |
| Horizon Nj Total Care | $100 | 55% |
| Hudson Headwaters Pace | $100 | 55% |
| Humana | $100 - $218 | 55% |
| Huron Valley Pace | $100 | 55% |
| Innovative Integrated Health Community Plans | $100 | 55% |
| Johns Hopkins Advantage Md | $100 | 55% |
| Lasso Healthcare Msa | $100 | 55% |
| Life St Marys Pace | $100 | 55% |
| Lifecircles Pace | $100 | 55% |
| Longevity Health Plan | $100 | 55% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $100 | 55% |
| Martins Point Generations Advantage | $100 | 55% |
| Mass General Brigham Mcr Adv | $100 | 55% |
| Medicare (plans) | $100 - $136 | 55% |
| Medipak Advantage | $100 | 55% |
| Mercy Life | $100 | 55% |
| Mercyone Cedar Valley | $100 | 55% |
| Meridian Complete | $100 | 55% |
| Michigan Complete Health | $100 | 55% |
| Nascentia Health Plus | $100 | 55% |
| New Centry Health Careplus | $100 | 55% |
| Osu Prime Care Advantage | $100 | 55% |
| Pace Cny | $100 | 55% |
| Pace Iowa Immanuel Pathways | $100 | 55% |
| Pace Of Southwest Michigan | $100 - $150 | 55% |
| Pace Southeast | $100 | 55% |
| Pace-Trinity Health | $100 | 55% |
| Peak Pace Solutions | $100 | 55% |
| Perennial Advantage | $100 | 55% |
| Preferred Care Partners | $100 | 55% |
| Presbyterian Senior Plan | $100 | 55% |
| Provider Partners Health Plan Of Illinois | $100 | 55% |
| Provider Partners Health Plan Of Indiana | $100 | 55% |
| Pruitthealth Premier | $100 | 55% |
| Reliance Community Care Partners Care Resources Pace | $100 | 55% |
| Rx Allwin | $100 | 55% |
| Rx Grane Grnmedd | $100 | 55% |
| Rx Retiree Rx Care | $100 | 55% |
| Scan Health Plan Mcr Ipa Meritage Oon | $100 | 55% |
| Secure Horizons Ma Pffs | $100 | 55% |
| Serenity Pace | $100 | 55% |
| Siouxland Pace | $100 | 55% |
| Solis Health Plans | $100 | 55% |
| Sunnyview-Pace Finance Dept | $100 | 55% |
| Texan Plus | $100 | 55% |
| The Health Plan | $100 | 55% |
| Thome Pace | $100 | 55% |
| Todays Options | $100 | 55% |
| Tribute Health Plans | $100 | 55% |
| Um Health Advantage | $100 | 55% |
| Union Health Service | $100 | 55% |
| UnitedHealthcare | $100 - $1,040 | 55% |
| Welbe Health | $100 | 55% |
| Wellmed | $100 | 55% |
| Champva | $105 | 58% |
| Iowa Health Advantage | $105 | 58% |
| Tricare | $105 | 58% |
| Triwest Health Alliance | $105 | 58% |
| Us Family Health Plan | $105 | 58% |
| Veterans Eval Services | $105 | 58% |
| American Health Plan | $119 | 66% |
| Veterans Administration | $127 | 70% |
| Wc Corvel | $129 | 71% |
| Amish Hospital Aid | $136 | 75% |
| Naphcare | $138 | 76% |
| Naphcare Correctional | $138 | 76% |
| Amps | $147 | 81% |
| Albany County Correctional Facility | $150 | 83% |
| Ambetter / Centene | $150 - $174 | 83% |
| Amish Mennonite | $150 | 83% |
| Ascension St. Vincent Public Safety Medical | $150 | 83% |
| Bcccp-Michigan | $150 | 83% |
| Bccp | $150 | 83% |
| Bmc Healthnet | $150 | 83% |
| Breast Grant-Connecticut | $150 | 83% |
| Broward County Dept Of Health | $150 | 83% |
| California Health And Wellness | $150 | 83% |
| Can Community Health Inc | $150 | 83% |
| Cardinal Innovations Lme | $150 | 83% |
| Care Connections Of Northern Iowa | $150 | 83% |
| Care Oregon Ohp | $150 | 83% |
| Cencal Health Plan | $150 | 83% |
| Cenpatico | $150 | 83% |
| Chhuny | $150 | 83% |
| Childrens Comm Health Plan | $150 | 83% |
| Childrens Medical Services Title 19 | $150 | 83% |
| City Of Philadelphia | $150 | 83% |
| Cmh Allegan County | $150 | 83% |
| Cmh Ausable Valley | $150 | 83% |
| Cmh Barry County | $150 | 83% |
| Cmh Bay-Arenac County | $150 | 83% |
| Cmh Berrien County | $150 | 83% |
| Cmh Cass County | $150 | 83% |
| Cmh Central Mi County | $150 | 83% |
| Cmh Clinton-Eaton-Ingham County | $150 | 83% |
| Cmh Detroit Wayne Integrated Health Network | $150 | 83% |
| Cmh Genesee County | $150 | 83% |
| Cmh Ionia County | $150 | 83% |
| Cmh Jackson County/Lifeways | $150 | 83% |
| Cmh Kalamazoo | $150 | 83% |
| Cmh Kent County | $150 | 83% |
| Cmh Lenawee County | $150 | 83% |
| Cmh Livingston County | $150 | 83% |
| Cmh Macomb | $150 | 83% |
| Cmh Misc | $150 | 83% |
| Cmh Monroe County | $150 | 83% |
| Cmh Montcalm County | $150 | 83% |
| Cmh Muskegon County | $150 | 83% |
| Cmh Newaygo County | $150 | 83% |
| Cmh North Country | $150 | 83% |
| Cmh Northern Lakes County | $150 | 83% |
| Cmh Oakland County | $150 | 83% |
| Cmh Ottawa County | $150 | 83% |
| Cmh Van Buren County | $150 | 83% |
| Cmh Washtenaw County | $150 | 83% |
| Cmh Wayne County/Carelink | $150 | 83% |
| Cmh Wayne Cty/Com Liv Svcs | $150 | 83% |
| Cmh West Mi County | $150 | 83% |
| Community Benefit Health | $150 | 83% |
| Community Care Behavorial Health | $150 | 83% |
| Community Care Partners | $150 | 83% |
| Community Health Choice | $150 | 83% |
| Connections Csp | $150 | 83% |
| County Coroner | $150 | 83% |
| County Funding Generic | $150 | 83% |
| Covid19 Hrsa Uninsured Testing And Treatment Fund | $150 | 83% |
| Dean Wi Badgercare | $150 | 83% |
| Delaware County Department Of Health | $150 | 83% |
| Delaware First Health | $150 | 83% |
| Delta Dental Nj | $150 | 83% |
| Dph Tb Program | $150 | 83% |
| Dscc | $150 | 83% |
| Eastpointe Lme | $150 | 83% |
| Family Health Network | $150 | 83% |
| Freedom First Healthcare | $150 | 83% |
| Fresno County Ccs | $150 | 83% |
| Ghc Scw Wi Badgercare | $150 | 83% |
| Harbor Health | $150 | 83% |
| Health Safety Net | $150 | 83% |
| Healthy Blue Ne | $150 | 83% |
| Hennepin Health | $150 | 83% |
| Id County Ada | $150 | 83% |
| Id County Canyon | $150 | 83% |
| Id County Cat Fund | $150 | 83% |
| Id County Other | $150 | 83% |
| Id County Payette | $150 | 83% |
| Idaho Dept Health And Wellfare | $150 | 83% |
| Idaho Womens Health Check | $150 | 83% |
| Indiana Breast Cervical Cancer | $150 | 83% |
| Inland Empire Health Plan | $150 | 83% |
| Intercommunity Health Ohp | $150 | 83% |
| Jai Medical System | $150 | 83% |
| Kern Family Health Plan | $150 | 83% |
| Keystone First | $150 | 83% |
| Keystone First Chip | $150 | 83% |
| La Care Health Plan | $150 | 83% |
| Lakeland Care Inc | $150 | 83% |
| Managed Health Services - Indiana | $150 | 83% |
| Maryland Breast & Cervical Program | $150 | 83% |
| Maryland Healthy Smiles - Scion Dental | $150 | 83% |
| Maryland Physicians Care | $150 | 83% |
| Massachusetts Behavioral Health Partnership | $150 | 83% |
| Mdwise | $150 | 83% |
| Medi-Cal | $150 | 83% |
| Medi-Cal Healthnet | $150 | 83% |
| Medstar Dc Healthy Family | $150 | 83% |
| Medstar Md Health Choice | $150 | 83% |
| Mo Home State Health Plan | $150 | 83% |
| Molina Centennial Care | $150 | 83% |
| Nascentia Health Options | $150 | 83% |
| New York Cancer Services Program | $150 | 83% |
| Nextlevel Health | $150 | 83% |
| Oregon Screenwise | $150 | 83% |
| Paramount Advantage | $150 | 83% |
| Parkland Community Health Plan | $150 | 83% |
| Partners Behavioral Lme | $150 | 83% |
| Peach State Healthplan | $150 | 83% |
| Philadelphia County Funding | $150 | 83% |
| Presbyterian Centennial Care | $150 | 83% |
| Prestige Health Choice | $150 | 83% |
| Priority Partners | $150 | 83% |
| Robert F Sing Program | $150 | 83% |
| Rx 340B Pass Along | $150 | 83% |
| Rx Assistance/Rx Manufacturer Assistance 0 Copay | $150 | 83% |
| Rx Medi-Cal | $150 | 83% |
| Rx Meridian Rx | $150 | 83% |
| Ryan White Florida Mssrp | $150 | 83% |
| Sandhills Center Lme | $150 | 83% |
| Screening For Life | $150 | 83% |
| St Joseph County Hlth Dpt | $150 | 83% |
| Sunshine State Health Plan | $150 | 83% |
| Superior Health | $150 | 83% |
| Tenncare | $150 | 83% |
| Texas Children'S Health Plan | $150 | 83% |
| Trillium Community Ohp | $150 | 83% |
| Tufts Health Public Plans | $150 | 83% |
| Vaya Health Lme | $150 | 83% |
| Washtenaw Health Plan | $150 | 83% |
| Wellsense Health Plan | $150 | 83% |
| Wi Womens Wellness | $150 | 83% |
| Iowa Total Care | $153 | 84% |
| Avera | $154 | 85% |
| Wellpoint | $155 | 85% |
| Bcn Domestic | $160 - $181 | 88% |
| Blue Benefit Administrators Of Massachusetts | $160 - $181 | 88% |
| Blue Care Network | $160 - $181 | 88% |
| Blue Distinction Transplant | $160 - $181 | 88% |
| Blue Shield - Ca | $160 - $181 | 88% |
| Blue Shield - Id (Regence) | $160 - $181 | 88% |
| Blue Shield - Ny Highmark Northeastern | $160 - $181 | 88% |
| Blue Shield - Ny Highmark Western | $160 - $181 | 88% |
| Blue Shield - Pa (Highmark) | $160 - $181 | 88% |
| Blue Shield - Wa (Regence) | $160 - $181 | 88% |
| Health Choices | $160 - $216 | 88% |
| Kaiser Domestic | $160 - $181 | 88% |
| Pre-Employment | $160 - $181 | 88% |
| Wc Domestic | $160 - $181 | 88% |
| Sanford Health Plan | $165 | 91% |
| Medical Associates | $171 - $202 | 94% |
| Preferred Health Choice | $171 | 94% |
| Health Partners | $175 - $563 | 97% |
| Stephenson Cty Health | $175 | 97% |
| Ucare | $180 | 99% |
| Lucent Health | $184 - $766 | 101% |
| Health Smart | $189 | 104% |
| Usa Managed Care | $198 | 109% |
| Claimdoc | $213 | 117% |
| The Alliance | $214 | 118% |
| Allied Benefit Systems | $216 - $766 | 119% |
| Auxiant | $216 - $609 | 119% |
| First Choice Health | $216 | 119% |
| Group Administrators | $216 | 119% |
| Midlands | $216 - $609 | 119% |
| Midlands Choice | $216 - $609 | 119% |
| Meritain | $226 - $766 | 125% |
| Global Excel | $231 | 127% |
| Velocity | $240 | 132% |
| Newton Correctional Facility | $245 | 135% |
| Quiktrip | $247 | 136% |
| Preferred One | $258 | 142% |
| Centivo | $265 | 146% |
| Genex Wc | $283 | 156% |
| Geha | $287 - $1,040 | 158% |
| Wc Align Network | $302 | 167% |
| Wc Praxis Health Network | $320 | 176% |
| Wc Reny Company | $328 | 181% |
| Wc Velocity | $328 | 181% |
| Auto Velocity | $339 | 187% |
| Multiplan | $339 | 187% |
| Wc O'Hara Corp | $339 | 187% |
| Andrie Inc | $377 | 208% |
| East Greenbush Central School District | $377 | 208% |
| Healthsmart Workers Comp | $377 | 208% |
| Iowa Dept Of Public Health | $377 - $858 | 208% |
| Jag Source | $377 | 208% |
| New York State Insurance Fund | $377 | 208% |
| Njm Insurance Group | $377 | 208% |
| Oscar | $377 | 208% |
| Rx Heatlhcomp | $377 | 208% |
| Rx Restat | $377 | 208% |
| Rx Saif Opdp Wc | $377 | 208% |
| Rx Worker'S Comp | $377 | 208% |
| Wc Accident Fund | $377 | 208% |
| Wc Ace | $377 | 208% |
| Wc Acs Federal Employees | $377 | 208% |
| Wc Acuity | $377 | 208% |
| Wc Advantage | $377 | 208% |
| Wc Aegis | $377 | 208% |
| Wc Aig | $377 | 208% |
| Wc Aims | $377 | 208% |
| Wc Alaska National Ins | $377 | 208% |
| Wc Allied | $377 | 208% |
| Wc Am Trust N America | $377 | 208% |
| Wc American Claims Mgmt | $377 | 208% |
| Wc Amerisure | $377 | 208% |
| Wc Amtrust | $377 | 208% |
| Wc Asu Risk Mgt | $377 | 208% |
| Wc Benetech | $377 | 208% |
| Wc Berkley Admin | $377 | 208% |
| Wc Broadspire | $377 | 208% |
| Wc Broward County | $377 | 208% |
| Wc Bunch & Associates | $377 | 208% |
| Wc California State Comp Ins | $377 | 208% |
| Wc California State Ins Fund | $377 | 208% |
| Wc Capitol Area Health Consortium | $377 | 208% |
| Wc Ccmsi | $377 | 208% |
| Wc Chartis | $377 | 208% |
| Wc Chubb | $377 | 208% |
| Wc Cirma | $377 | 208% |
| Wc City Of Albany | $377 | 208% |
| Wc City Of Sioux City | $377 | 208% |
| Wc Claims Mgmt Inc | $377 | 208% |
| Wc Cna | $377 | 208% |
| Wc Comp One Admin C/O Manageability | $377 | 208% |
| Wc Compone Admin | $377 | 208% |
| Wc Ct Healthcare Trust | $377 | 208% |
| Wc Donegal Insurance Group | $377 | 208% |
| Wc Emc Insurance Company | $377 | 208% |
| Wc Employee Mutual | $377 | 208% |
| Wc Enablecomp | $377 | 208% |
| Wc Encore Health Network | $377 | 208% |
| Wc Erie | $377 | 208% |
| Wc Esis | $377 | 208% |
| Wc Evolutions | $377 | 208% |
| Wc Fcci | $377 | 208% |
| Wc Fed Ex | $377 | 208% |
| Wc Federal Black Lung | $377 | 208% |
| Wc Federated | $377 | 208% |
| Wc Finley Occupational Health | $377 | 208% |
| Wc First Agency/Occunet | $377 | 208% |
| Wc Ford Motor | $377 | 208% |
| Wc Fresno Unified Emp | $377 | 208% |
| Wc Gallagher Bassett | $377 | 208% |
| Wc General Motors | $377 | 208% |
| Wc Generic | $377 | 208% |
| Wc Genex Care For Ohio | $377 | 208% |
| Wc Great West Casualty | $377 | 208% |
| Wc Guarantee Insurance | $377 | 208% |
| Wc Guard Insurance Company | $377 | 208% |
| Wc Hab | $377 | 208% |
| Wc Hartford | $377 | 208% |
| Wc Hastings | $377 | 208% |
| Wc Health Management | $377 | 208% |
| Wc Heritage Summit | $377 | 208% |
| Wc Hireright | $377 | 208% |
| Wc Horizon | $377 | 208% |
| Wc Icw Group | $377 | 208% |
| Wc Idaho State Ins Fund | $377 | 208% |
| Wc Intercare Insurance | $377 | 208% |
| Wc Intermountain | $377 | 208% |
| Wc Johns Eastern | $377 | 208% |
| Wc Kemberton | $377 | 208% |
| Wc Key Ins & Benefit Solutions | $377 | 208% |
| Wc Liberty Mutual | $377 | 208% |
| Wc Mac Risk Management | $377 | 208% |
| Wc Massachusetts | $377 | 208% |
| Wc Mdia | $377 | 208% |
| Wc Meadowbrook Claim | $377 | 208% |
| Wc Medical Administrators | $377 | 208% |
| Wc Meijers | $377 | 208% |
| Wc Memic | $377 | 208% |
| Wc Mercy Workcare | $377 | 208% |
| Wc Michigan | $377 | 208% |
| Wc Michigan Millers Mutual | $377 | 208% |
| Wc Mitchell Frankenmuth | $377 | 208% |
| Wc Mra | $377 | 208% |
| Wc Nationwide | $377 | 208% |
| Wc Nca Comp | $377 | 208% |
| Wc New York | $377 | 208% |
| Wc New York Special Funds | $377 | 208% |
| Wc North American Rishces | $377 | 208% |
| Wc Northeast Health | $377 | 208% |
| Wc Notre Dame | $377 | 208% |
| Wc Novanet | $377 | 208% |
| Wc Occ Health Allen | $377 | 208% |
| Wc Ohio Bureau | $377 | 208% |
| Wc One Call Medical | $377 | 208% |
| Wc Paradigm | $377 | 208% |
| Wc Peerless | $377 | 208% |
| Wc Pma | $377 | 208% |
| Wc Price Chopper | $377 | 208% |
| Wc Procura Management | $377 | 208% |
| Wc Qualcare | $377 | 208% |
| Wc Quiktrip | $377 | 208% |
| Wc Rev Claims | $377 | 208% |
| Wc Risico | $377 | 208% |
| Wc Rural Mutual | $377 | 208% |
| Wc Saif Oregon | $377 | 208% |
| Wc Secura | $377 | 208% |
| Wc Sedgwick | $377 | 208% |
| Wc Sentry | $377 | 208% |
| Wc Sheakley Unicomp | $377 | 208% |
| Wc Smile Lodge | $377 | 208% |
| Wc Society | $377 | 208% |
| Wc Srs | $377 | 208% |
| Wc Taconic (Mro) | $377 | 208% |
| Wc Taconic Farms | $377 | 208% |
| Wc Travelers | $377 | 208% |
| Wc Triad Group | $377 | 208% |
| Wc Tristar | $377 | 208% |
| Wc Troy Ny | $377 | 208% |
| Wc Tyson | $377 | 208% |
| Wc Unified Health Services | $377 | 208% |
| Wc United Heartland | $377 | 208% |
| Wc Us Dept Of Labor | $377 | 208% |
| Wc Walmart | $377 | 208% |
| Wc West Bend | $377 | 208% |
| Wc West Bend Mutual/Argent | $377 | 208% |
| Wc Winnebago Industries | $377 | 208% |
| Wc Yankee Trails | $377 | 208% |
| Wc York Risk | $377 | 208% |
| Wc Zenith | $377 | 208% |
| Wc Zurich | $377 | 208% |
| Medica | $609 | 336% |
| Asr Health Benefits | $766 | 422% |
| Christian Brother Services | $766 | 422% |
| Coventry | $766 | 422% |
| First Health | $766 | 422% |
| Luminare Health | $766 | 422% |
| Medical Mutual | $766 | 422% |
| Webtpa | $766 | 422% |