CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Iowa Specialty Hospital - Clarion

Billing Code: 90791 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$198

about 1.1× the $181 Medicare rate · typically $142–$376

modeled estimate · not a bill or quote

What this hospital charges insurers

$156

Below the fair price — a good deal

about $42 under the fair price · 0.9× Medicare

Medicare pays $181 Fair price $198 This hospital $156 Cash price $239 Hospital's list price $399

How we calculate the fair BaseRate →

How this hospital compares to other IA hospitals

Highest price of the 9 IA hospitals we have prices for — worth calling around.

Cheapest $113 Priciest $156

Black dot = this hospital, among the 9 IA hospitals with a price for this procedure. Full list below.

A fair price for a Psychiatric evaluation (first visit) is about $198 (about 1.1× the $181 Medicare rate). Iowa Specialty Hospital - Clarion charges insurers about $156, or about $239 in cash — below the fair price — a good deal. Located in Clarion, IA.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

4 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna HumanaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$218	120%
Blue Cross Blue Shieldmajor	$148	82%
Aetnamajor	$124	68%
Cignamajor	$156	86%
HealthPartners	$170 - $375	94%
+ 2 smaller / regional plans	$194 - $325

Government programs also on file: Military & VA.

Excludes 2 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 239), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 90791.

Insurance Before you use insurance

Call your insurance company to confirm Iowa Specialty Hospital - Clarion is in-network.
Ask your insurer whether prior approval is required for CPT code 90791.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Iowa Specialty Hospital - Clarion

Compare: Psychiatric evaluation (first visit) at other IA hospitals

Insurance negotiated median for the same procedure, sorted lowest first.