CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: St Lukes Regional Medical Center

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90791
  • Insurance Median: $194
  • Cash Discount Price: $266
  • vs. Medicare Baseline: 1.07x Medicare
The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at St Lukes Regional Medical Center is $194. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $266. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.07x the Medicare baseline. Located in 2720 Stone Park Boulevard, Sioux City, IA.
Cash / Self-Pay
$266

Average discount available for prompt cash payment at this facility.

Insurance Median
$194

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: $266 (147%)
Insurance Median: $194 (107%)
Cash: $266 (147% of Medicare)
Ins. Median: $194 (107% 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
Nebraska Total Care $86 - $105 47%
Aetna $140 - $393 77%
Amerigroup $142 78%
Iowa Total Care $142 78%
Blue Cross Blue Shield $143 - $208 79%
Molina $143 - $160 79%
Amerivantage $147 - $164 81%
Humana $147 - $164 81%
UnitedHealthcare $147 - $429 81%
Medica Exchange Inspire $171 94%
Medica Exchange Insure $192 106%
Health Partners Open Network $197 - $240 109%
Wellmark Uph Self-Funded $208 115%
Cigna $209 - $369 115%
Avera Health Plan $210 - $216 116%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2720 Stone Park Boulevard, Sioux City, IA 51104
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals