CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Northwestern Medicine Central Dupage Hospital

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90791
Insurance Median: $303
Cash Discount Price: $407
vs. Medicare Baseline: 1.67x Medicare

The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Northwestern Medicine Central Dupage Hospital is $303. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $407. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.67x the Medicare baseline. Located in 25 North Winfield Road, Winfield, IL.

Cash / Self-Pay

$407

Average discount available for prompt cash payment at this facility.

Insurance Median

$303

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: $407 (224%)

Insurance Median: $303 (167%)

Cash: $407 (224% of Medicare)

Ins. Median: $303 (167% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Aetna	$21 - $872	12%
Blue Cross Blue Shield	$26 - $1,514	14%
Cigna	$32 - $1,211	18%
Countycare Il Cook Co [1607]	$34 - $104	19%
Medicaid / KanCare	$34 - $104	19%
Health'S Finest Network [126]	$74 - $1,381	41%
UnitedHealthcare	$75 - $1,514	41%
Multiplan/Phcs [142]	$86 - $1,514	47%
Dreyer Med Ipa Advocate [1409]	$89 - $908	49%
Humana	$89 - $1,514	49%
Magellan Behavioral Hlth [136]	$89 - $908	49%
Healthlink [125]	$94 - $954	52%
The Alliance [1703]	$96 - $972	53%
Choicecare [177]	$114 - $1,160	63%
First Health Plan [6034]	$115 - $1,164	63%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $407.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 90791.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Northwestern Medicine Central Dupage Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 90791.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.