CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Kossuth Regional Health Center

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90791
  • Insurance Median: $216
  • Cash Discount Price: $203
  • vs. Medicare Baseline: 1.19x Medicare
The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Kossuth Regional Health Center is $216. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $203. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.19x the Medicare baseline. Located in 1515 South Phillips Street, Algona, IA.
Cash / Self-Pay
$203

Average discount available for prompt cash payment at this facility.

Insurance Median
$216

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: $203 (112%)
Insurance Median: $216 (119%)
Cash: $203 (112% of Medicare)
Ins. Median: $216 (119% 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
Humana $136 75%
Va Ccn - All Plans $136 75%
Amerigroup Mcr Adv - All Other Plans $139 77%
UnitedHealthcare $140 - $385 77%
Mercy One - All Plans $143 79%
Sanford Pho Isno Mcr Adv Profee Only - All Plans $143 79%
Midlands Choice - All Plans $190 105%
Health Partners New Bus - All Other Plans $206 114%
Blue Cross Blue Shield $208 115%
Medical Associates - All Plans $225 124%
Preferred Health - All Plans $225 124%
Health Partners Exisiting Bus $226 125%
Multiplan - All Plans $241 133%
Molina Mcaid/Chip - All Plans $260 143%
Amerigroup Mcaid $261 144%
Aetna $306 - $337 169%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1515 South Phillips Street, Algona, IA 50511
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals