CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Community Hospital of Staunton

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90791
  • Insurance Median: $339
  • Cash Discount Price: $210
  • vs. Medicare Baseline: 1.87x Medicare
The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Community Hospital of Staunton is $339. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $210. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.87x the Medicare baseline. Located in 400 N Caldwell St, Staunton, IL.
Cash / Self-Pay
$210

Average discount available for prompt cash payment at this facility.

Insurance Median
$339

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: $210 (116%)
Insurance Median: $339 (187%)
Cash: $210 (116% of Medicare)
Ins. Median: $339 (187% 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
Tricare $122 - $163 67%
Medicare (plans) $124 - $168 68%
Clear Spring Health Ma $128 - $173 71%
Self Pay $210 116%
UnitedHealthcare $218 - $421 120%
Cigna $271 149%
Blue Cross Blue Shield $316 - $421 174%
Healthlink $316 - $358 174%
Health Alliance Commercial $337 - $421 186%
Aetna $341 - $421 188%
Multiplan/Phcs $358 197%
Beech Street $383 211%
Medicaid / KanCare $421 - $514 232%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 400 N Caldwell St, Staunton, IL 62088
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals