CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Wabash General Hospital 1

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90791
  • Insurance Median: $165
  • Cash Discount Price: $220
  • vs. Medicare Baseline: 0.91x Medicare
The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Wabash General Hospital 1 is $165. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $220. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 0.91x the Medicare baseline. Located in 1418 College Drive, Mount Carmel, IL.
Cash / Self-Pay
$220

Average discount available for prompt cash payment at this facility.

Insurance Median
$165

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: $220 (121%)
Insurance Median: $165 (91%)
Cash: $220 (121% of Medicare)
Ins. Median: $165 (91% 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
Blue Cross Blue Shield $54 - $600 30%
UnitedHealthcare $56 - $208 31%
Health Alliance Mcr Adv - All Plans $58 - $82 32%
Aetna $120 - $600 66%
Healthlink Hmo $127 - $182 70%
Cigna $136 - $195 75%
Encore Combined Ip/Op Only $136 - $195 75%
Hope Trust - All Plans $136 - $195 75%
Healthlink Ppo - All Other Plans $146 - $208 81%
Phcs - All Plans $146 - $208 81%
Health Smart - All Plans $155 - $221 85%
Hfn - All Plans $155 - $221 85%
Multiplan - All Plans $155 - $221 85%
Siho Network - All Plans $155 - $221 85%
Encore Health Network Ip/Op Only - All Other Plans $164 - $234 90%
Meridian Mcaid - All Plans $600 331%
Molina Mcaid - All Plans $600 331%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1418 College Drive, Mount Carmel, IL 62863
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals