CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: St Marys Hospital

Billing Code: 90791 (CPT)

The BaseRate · fair price high confidence
A fair price for this
$185
about 1.0× the $181 Medicare rate · typically $165–$202
modeled estimate · not a bill or quote
What this hospital charges insurers
$200
About the fair price
about $15 over the fair price · 1.1× Medicare
Medicare pays $181 Fair price $185 This hospital $200 Cash price $347 Hospital's list price $482

How we calculate the fair BaseRate →

How this hospital compares to other IL hospitals

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

Cheapest $119 Priciest $200

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

A fair price for a Psychiatric evaluation (first visit) is about $185 (about 1.0× the $181 Medicare rate). St Marys Hospital charges insurers about $200, or about $347 in cash — about the fair price. Located in Decatur, IL.

What each insurance company pays

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

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

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser 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 $190 - $482 105%
Blue Cross Blue Shieldmajor $190 105%
Aetnamajor $175 - $265 97%
Cignamajor $294 - $410 162%
Humanamajor $190 105%
HealthLink $381 - $482 210%
Meridian $237 131%
Molina $200 - $226 110%
+ 16 smaller / regional plans $135 - $482
Excludes 4 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

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Facility Profile & Credentials

  • Address: 1800 E Lake Shore Dr, Decatur, IL 62521
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals