CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Northwest Health-La Porte

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90791
  • Insurance Median: $273
  • Cash Discount Price: $151
  • vs. Medicare Baseline: 1.51x Medicare
The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Northwest Health-La Porte is $273. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $151. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.51x the Medicare baseline. Located in 1007 Lincolnway, La Porte, IN.
Cash / Self-Pay
$151

Average discount available for prompt cash payment at this facility.

Insurance Median
$273

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: $151 (83%)
Insurance Median: $273 (151%)
Cash: $151 (83% of Medicare)
Ins. Median: $273 (151% 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
Lutheran $92 - $95 51%
Self Pay $113 - $191 62%
One Call $136 75%
Php $141 - $146 78%
Lutheran Preferred Medpartners $143 - $148 79%
Alpha Baking $154 - $159 85%
UnitedHealthcare $167 - $258 92%
Aetna $185 - $292 102%
Blue Cross Blue Shield $185 - $765 102%
Humana $185 102%
Medicare (plans) $185 102%
Node Hospice Non Par Agree $188 104%
Node Va $188 104%
Va Choice Program $188 104%
Node Devoted Health Mcr Adv $189 104%
Managed Health Services $194 - $376 107%
Indiana Dept Of Correction $196 108%
Node Pphp Mcr Adv $198 109%
Php Freedom Network $206 - $212 114%
Encore $222 - $339 122%
Us Department Of Labor $235 130%
County Of Laporte $239 - $247 132%
Cigna $254 - $262 140%
Prime Health Services $256 - $265 141%
Prime Health Services Auto $256 - $265 141%
Ihn $274 - $282 151%
Community Health Alliance $298 - $307 164%
Lutheran Network $301 - $376 166%
Sagamore Health Network $301 - $311 166%
Chandler Group $308 - $318 170%
Hfn Workers Compensation $308 - $318 170%
Multiplan $308 - $318 170%
Phcs $308 - $318 170%
Prime Health In Work Comp $339 187%
In Wc $376 207%
Encore Kba Epo $452 249%
Magnacare Ma $461 254%
Encore Kba Ppo $565 312%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1007 Lincolnway, La Porte, IN 46350
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals