CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Kootenai Health

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90791
  • Insurance Median: $185
  • Cash Discount Price: $294
  • vs. Medicare Baseline: 1.02x Medicare
The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Kootenai Health is $185. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $294. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.02x the Medicare baseline. Located in 2003 Kootenai Health Way, Coeur D'Alene, ID.
Cash / Self-Pay
$294

Average discount available for prompt cash payment at this facility.

Insurance Median
$185

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: $294 (162%)
Insurance Median: $185 (102%)
Cash: $294 (162% of Medicare)
Ins. Median: $185 (102% 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
Coordinated Care Of Washington $71 39%
Molina Healthcare Of Idaho $71 - $189 39%
Molina Healthcare Of Washington $71 39%
Magellan $126 - $140 69%
Wellpoint $126 - $140 69%
Blue Cross Blue Shield $136 - $353 75%
Humana $136 - $183 75%
Premera $136 - $242 75%
Regence Blue Shield Of Idaho $136 - $183 75%
UnitedHealthcare $136 - $353 75%
Pacificsource $138 - $321 76%
Aetna $143 - $325 79%
Group Health/Kaiser $154 - $660 85%
Mountain Health Co-Op $304 168%
Cigna $321 - $326 177%
Interwest Health $333 184%
First Choice Health (Ameriben) $334 - $339 184%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2003 Kootenai Health Way, Coeur D'Alene, ID 83814
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals