CMS Price Transparency Data
Psychiatric evaluation (first visit)
Facility: Saint Joseph Regional Medical Center
Billing Code: 90791 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 90791
- Insurance Median: $166
- Cash Discount Price: $364
- vs. Medicare Baseline: 0.92x Medicare
The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Saint Joseph Regional Medical Center is $166. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $364. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 0.92x the Medicare baseline. Located in 5215 Holy Cross Pkwy, Mishawaka, IN.
Cash / Self-Pay
$364
Average discount available for prompt cash payment at this facility.
Insurance Median
$166
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: $364 (201%)
Insurance Median: $166 (92%)
Cash: $364 (201% of Medicare)
Ins. Median: $166 (92% 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
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Saint Pius X | $75 | 41% |
| Medicaid / KanCare | $122 - $364 | 67% |
| Aetna | $162 - $178 | 89% |
| Albany County Correctional Facility | $162 | 89% |
| Ambetter / Centene | $162 | 89% |
| Amish Mennonite | $162 | 89% |
| Ascension St. Vincent Public Safety Medical | $162 | 89% |
| Bcccp-Michigan | $162 | 89% |
| Bccp | $162 | 89% |
| Blue Cross Blue Shield | $162 - $202 | 89% |
| Bmc Healthnet | $162 | 89% |
| Breast Grant-Connecticut | $162 | 89% |
| Broward County Dept Of Health | $162 | 89% |
| California Health And Wellness | $162 | 89% |
| Cardinal Innovations Lme | $162 | 89% |
| Care Connections Of Northern Iowa | $162 | 89% |
| Care Oregon Ohp | $162 | 89% |
| Cencal Health Plan | $162 | 89% |
| Cenpatico | $162 | 89% |
| Champva | $162 | 89% |
| Chhuny | $162 | 89% |
| Childrens Comm Health Plan | $162 | 89% |
| Childrens Medical Services Title 19 | $162 | 89% |
| Cigna | $162 - $364 | 89% |
| City Of Philadelphia | $162 | 89% |
| Cmh Allegan County | $162 | 89% |
| Cmh Ausable Valley | $162 | 89% |
| Cmh Barry County | $162 | 89% |
| Cmh Bay-Arenac County | $162 | 89% |
| Cmh Berrien County | $162 | 89% |
| Cmh Cass County | $162 | 89% |
| Cmh Central Mi County | $162 | 89% |
| Cmh Clinton-Eaton-Ingham County | $162 | 89% |
| Cmh Detroit Wayne Integrated Health Network | $162 | 89% |
| Cmh Genesee County | $162 | 89% |
| Cmh Ionia County | $162 | 89% |
| Cmh Jackson County/Lifeways | $162 | 89% |
| Cmh Kalamazoo | $162 | 89% |
| Cmh Kent County | $162 | 89% |
| Cmh Lenawee County | $162 | 89% |
| Cmh Livingston County | $162 | 89% |
| Cmh Macomb | $162 | 89% |
| Cmh Misc | $162 | 89% |
| Cmh Monroe County | $162 | 89% |
| Cmh Montcalm County | $162 | 89% |
| Cmh Muskegon County | $162 | 89% |
| Cmh Newaygo County | $162 | 89% |
| Cmh North Country | $162 | 89% |
| Cmh Northern Lakes County | $162 | 89% |
| Cmh Oakland County | $162 | 89% |
| Cmh Ottawa County | $162 | 89% |
| Cmh Van Buren County | $162 | 89% |
| Cmh Washtenaw County | $162 | 89% |
| Cmh Wayne County/Carelink | $162 | 89% |
| Cmh Wayne Cty/Com Liv Svcs | $162 | 89% |
| Cmh West Mi County | $162 | 89% |
| Community Benefit Health | $162 | 89% |
| Community Care Behavorial Health | $162 | 89% |
| Community Care Partners | $162 | 89% |
| Community Health Choice | $162 | 89% |
| Connections Csp | $162 | 89% |
| County Coroner | $162 | 89% |
| County Funding Generic | $162 | 89% |
| Covid19 Hrsa Uninsured Testing And Treatment Fund | $162 | 89% |
| Dean Wi Badgercare | $162 | 89% |
| Delaware County Department Of Health | $162 | 89% |
| Delaware First Health | $162 | 89% |
| Delta Dental Nj | $162 | 89% |
| Dph Tb Program | $162 | 89% |
| Dscc | $162 | 89% |
| Eastpointe Lme | $162 | 89% |
| Family Health Network | $162 | 89% |
| Freedom First Healthcare | $162 | 89% |
| Fresno County Ccs | $162 | 89% |
| Ghc Scw Wi Badgercare | $162 | 89% |
| Harbor Health | $162 | 89% |
| Health Safety Net | $162 | 89% |
| Healthy Blue Ne | $162 | 89% |
| Hennepin Health | $162 | 89% |
| Humana | $162 - $166 | 89% |
| Id County Ada | $162 | 89% |
| Id County Canyon | $162 | 89% |
| Id County Cat Fund | $162 | 89% |
| Id County Other | $162 | 89% |
| Id County Payette | $162 | 89% |
| Idaho Dept Health And Wellfare | $162 | 89% |
| Idaho Womens Health Check | $162 | 89% |
| Indiana Breast Cervical Cancer | $162 | 89% |
| Inland Empire Health Plan | $162 | 89% |
| Intercommunity Health Ohp | $162 | 89% |
| Iowa Total Care | $162 | 89% |
| Jai Medical System | $162 | 89% |
| Kern Family Health Plan | $162 | 89% |
| Keystone First | $162 | 89% |
| Keystone First Chip | $162 | 89% |
| La Care Health Plan | $162 | 89% |
| Lakeland Care Inc | $162 | 89% |
| Managed Health Services - Indiana | $162 | 89% |
| Maryland Breast & Cervical Program | $162 | 89% |
| Maryland Healthy Smiles - Scion Dental | $162 | 89% |
| Maryland Physicians Care | $162 | 89% |
| Massachusetts Behavioral Health Partnership | $162 | 89% |
| Mdwise | $162 | 89% |
| Medi-Cal | $162 | 89% |
| Medi-Cal Healthnet | $162 | 89% |
| Medstar Dc Healthy Family | $162 | 89% |
| Medstar Md Health Choice | $162 | 89% |
| Mo Home State Health Plan | $162 | 89% |
| Molina Centennial Care | $162 | 89% |
| Nascentia Health Options | $162 | 89% |
| Nebraska Total Care | $162 | 89% |
| New York Cancer Services Program | $162 | 89% |
| Nextlevel Health | $162 | 89% |
| Oregon Screenwise | $162 | 89% |
| Pace Of Southwest Michigan | $162 - $166 | 89% |
| Paramount Advantage | $162 | 89% |
| Parkland Community Health Plan | $162 | 89% |
| Partners Behavioral Lme | $162 | 89% |
| Peach State Healthplan | $162 | 89% |
| Philadelphia County Funding | $162 | 89% |
| Presbyterian Centennial Care | $162 | 89% |
| Prestige Health Choice | $162 | 89% |
| Priority Partners | $162 | 89% |
| Robert F Sing Program | $162 | 89% |
| Rx 340B Pass Along | $162 | 89% |
| Rx Assistance/Rx Manufacturer Assistance 0 Copay | $162 | 89% |
| Rx Medi-Cal | $162 | 89% |
| Rx Meridian Rx | $162 | 89% |
| Ryan White Florida Mssrp | $162 | 89% |
| Sandhills Center Lme | $162 | 89% |
| Screening For Life | $162 | 89% |
| St Joseph County Hlth Dpt | $162 | 89% |
| Stephenson Cty Health | $162 | 89% |
| Sunshine State Health Plan | $162 | 89% |
| Superior Health | $162 | 89% |
| Tenncare | $162 | 89% |
| Texas Children'S Health Plan | $162 | 89% |
| Tricare | $162 | 89% |
| Trillium Community Ohp | $162 | 89% |
| Triwest Health Alliance | $162 | 89% |
| Tufts Health Public Plans | $162 | 89% |
| UnitedHealthcare | $162 - $239 | 89% |
| Us Family Health Plan | $162 | 89% |
| Vaya Health Lme | $162 | 89% |
| Veterans Eval Services | $162 | 89% |
| Washtenaw Health Plan | $162 | 89% |
| Wellsense Health Plan | $162 | 89% |
| Wi Womens Wellness | $162 | 89% |
| Align Senior Care | $166 | 92% |
| Ally Align Care Adv | $166 | 92% |
| American Health Advantage Of Idaho | $166 | 92% |
| American Health Plan | $166 | 92% |
| Aurora Special Needs | $166 | 92% |
| Blue Care Network Advantage | $166 | 92% |
| Blue Shield - De (Highmark) Medciare Advantage | $166 | 92% |
| Care Dimensions | $166 | 92% |
| Care Improvement Plus | $166 | 92% |
| Care Resources Pace | $166 | 92% |
| Careplus Health Plans | $166 | 92% |
| Cca - Zing Health | $166 | 92% |
| Cca Senior Care Options | $166 | 92% |
| Central Valley Medical Services Corp Pace | $166 | 92% |
| Champion Health Plan Mcr Advantage | $166 | 92% |
| Clear Spring Health | $166 | 92% |
| Clover Health | $166 | 92% |
| Commonwealth Care Alliance | $166 | 92% |
| Community Pace At Home | $166 | 92% |
| Eddy Senior Care-Pace | $166 | 92% |
| Eddy Seniorcare Pace | $166 | 92% |
| Elementcare | $166 | 92% |
| Evercare | $166 | 92% |
| Everence | $166 | 92% |
| Gateway Health Plan | $166 | 92% |
| Genesys Pace Of Genesee County | $166 | 92% |
| Georgia Health Advantage | $166 | 92% |
| Gold Advantage | $166 | 92% |
| Gpa Croell Redi Mix | $166 | 92% |
| Health America Advantra | $166 | 92% |
| Highmark Health Options Dual Plan | $166 | 92% |
| Hope Select Pace | $166 | 92% |
| Horizon Nj Total Care | $166 | 92% |
| Hudson Headwaters Pace | $166 | 92% |
| Huron Valley Pace | $166 | 92% |
| Innovative Integrated Health Community Plans | $166 | 92% |
| Iowa Health Advantage | $166 | 92% |
| Johns Hopkins Advantage Md | $166 | 92% |
| Lasso Healthcare Msa | $166 | 92% |
| Life St Marys Pace | $166 | 92% |
| Lifecircles Pace | $166 | 92% |
| Longevity Health Plan | $166 | 92% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $166 | 92% |
| Martins Point Generations Advantage | $166 | 92% |
| Mass General Brigham Mcr Adv | $166 | 92% |
| Medicare (plans) | $166 - $173 | 92% |
| Medipak Advantage | $166 | 92% |
| Mercy Life | $166 | 92% |
| Mercyone Cedar Valley | $166 | 92% |
| Meridian Complete | $166 | 92% |
| Michigan Complete Health | $166 | 92% |
| Nascentia Health Plus | $166 | 92% |
| New Centry Health Careplus | $166 | 92% |
| Osu Prime Care Advantage | $166 | 92% |
| Pace Cny | $166 | 92% |
| Pace Iowa Immanuel Pathways | $166 | 92% |
| Pace Southeast | $166 | 92% |
| Pace-Trinity Health | $166 | 92% |
| Peak Pace Solutions | $166 | 92% |
| Perennial Advantage | $166 | 92% |
| Preferred Care Partners | $166 | 92% |
| Presbyterian Senior Plan | $166 | 92% |
| Provider Partners Health Plan Of Illinois | $166 | 92% |
| Pruitthealth Premier | $166 | 92% |
| Reliance Community Care Partners Care Resources Pace | $166 | 92% |
| Rx Allwin | $166 | 92% |
| Rx Grane Grnmedd | $166 | 92% |
| Rx Retiree Rx Care | $166 | 92% |
| Scan Health Plan Mcr Ipa Meritage Oon | $166 | 92% |
| Secure Horizons Ma Pffs | $166 | 92% |
| Serenity Pace | $166 | 92% |
| Siouxland Pace | $166 | 92% |
| Solis Health Plans | $166 | 92% |
| Sunnyview-Pace Finance Dept | $166 | 92% |
| Texan Plus | $166 | 92% |
| The Health Plan | $166 | 92% |
| Thome Pace | $166 | 92% |
| Todays Options | $166 | 92% |
| Tribute Health Plans | $166 | 92% |
| Um Health Advantage | $166 | 92% |
| Union Health Service | $166 | 92% |
| Welbe Health | $166 | 92% |
| Wellmed | $166 | 92% |
| Andrie Inc | $170 | 94% |
| East Greenbush Central School District | $170 | 94% |
| Genex Wc | $170 | 94% |
| Healthsmart Workers Comp | $170 | 94% |
| Jag Source | $170 | 94% |
| New York State Insurance Fund | $170 | 94% |
| Njm Insurance Group | $170 | 94% |
| Rx Heatlhcomp | $170 | 94% |
| Rx Restat | $170 | 94% |
| Rx Saif Opdp Wc | $170 | 94% |
| Rx Worker'S Comp | $170 | 94% |
| Veterans Administration | $170 | 94% |
| Wc Accident Fund | $170 | 94% |
| Wc Ace | $170 | 94% |
| Wc Acs Federal Employees | $170 | 94% |
| Wc Acuity | $170 | 94% |
| Wc Advantage | $170 | 94% |
| Wc Aegis | $170 | 94% |
| Wc Aig | $170 | 94% |
| Wc Aims | $170 | 94% |
| Wc Alaska National Ins | $170 | 94% |
| Wc Align Network | $170 | 94% |
| Wc Allied | $170 | 94% |
| Wc Am Trust N America | $170 | 94% |
| Wc American Claims Mgmt | $170 | 94% |
| Wc Amerisure | $170 | 94% |
| Wc Amtrust | $170 | 94% |
| Wc Asu Risk Mgt | $170 | 94% |
| Wc Benetech | $170 | 94% |
| Wc Berkley Admin | $170 | 94% |
| Wc Broadspire | $170 | 94% |
| Wc Broward County | $170 | 94% |
| Wc Bunch & Associates | $170 | 94% |
| Wc California State Comp Ins | $170 | 94% |
| Wc California State Ins Fund | $170 | 94% |
| Wc Capitol Area Health Consortium | $170 | 94% |
| Wc Ccmsi | $170 | 94% |
| Wc Chartis | $170 | 94% |
| Wc Chubb | $170 | 94% |
| Wc Cirma | $170 | 94% |
| Wc City Of Albany | $170 | 94% |
| Wc City Of Sioux City | $170 | 94% |
| Wc Claims Mgmt Inc | $170 | 94% |
| Wc Cna | $170 | 94% |
| Wc Comp One Admin C/O Manageability | $170 | 94% |
| Wc Compone Admin | $170 | 94% |
| Wc Corvel | $170 | 94% |
| Wc Ct Healthcare Trust | $170 | 94% |
| Wc Donegal Insurance Group | $170 | 94% |
| Wc Emc Insurance Company | $170 | 94% |
| Wc Employee Mutual | $170 | 94% |
| Wc Enablecomp | $170 | 94% |
| Wc Erie | $170 | 94% |
| Wc Esis | $170 | 94% |
| Wc Evolutions | $170 | 94% |
| Wc Fcci | $170 | 94% |
| Wc Fed Ex | $170 | 94% |
| Wc Federal Black Lung | $170 | 94% |
| Wc Federated | $170 | 94% |
| Wc Finley Occupational Health | $170 | 94% |
| Wc First Agency/Occunet | $170 | 94% |
| Wc Ford Motor | $170 | 94% |
| Wc Fresno Unified Emp | $170 | 94% |
| Wc Gallagher Bassett | $170 | 94% |
| Wc General Motors | $170 | 94% |
| Wc Generic | $170 | 94% |
| Wc Genex Care For Ohio | $170 | 94% |
| Wc Great West Casualty | $170 | 94% |
| Wc Guarantee Insurance | $170 | 94% |
| Wc Guard Insurance Company | $170 | 94% |
| Wc Hab | $170 | 94% |
| Wc Hartford | $170 | 94% |
| Wc Hastings | $170 | 94% |
| Wc Health Management | $170 | 94% |
| Wc Heritage Summit | $170 | 94% |
| Wc Hireright | $170 | 94% |
| Wc Horizon | $170 | 94% |
| Wc Icw Group | $170 | 94% |
| Wc Idaho State Ins Fund | $170 | 94% |
| Wc Intercare Insurance | $170 | 94% |
| Wc Intermountain | $170 | 94% |
| Wc Johns Eastern | $170 | 94% |
| Wc Kemberton | $170 | 94% |
| Wc Key Ins & Benefit Solutions | $170 | 94% |
| Wc Liberty Mutual | $170 | 94% |
| Wc Mac Risk Management | $170 | 94% |
| Wc Massachusetts | $170 | 94% |
| Wc Mdia | $170 | 94% |
| Wc Meadowbrook Claim | $170 | 94% |
| Wc Medical Administrators | $170 | 94% |
| Wc Meijers | $170 | 94% |
| Wc Memic | $170 | 94% |
| Wc Mercy Workcare | $170 | 94% |
| Wc Michigan | $170 | 94% |
| Wc Michigan Millers Mutual | $170 | 94% |
| Wc Mitchell Frankenmuth | $170 | 94% |
| Wc Mra | $170 | 94% |
| Wc Nationwide | $170 | 94% |
| Wc Nca Comp | $170 | 94% |
| Wc New York | $170 | 94% |
| Wc New York Special Funds | $170 | 94% |
| Wc North American Rishces | $170 | 94% |
| Wc Northeast Health | $170 | 94% |
| Wc Notre Dame | $170 | 94% |
| Wc Novanet | $170 | 94% |
| Wc O'Hara Corp | $170 | 94% |
| Wc Occ Health Allen | $170 | 94% |
| Wc Ohio Bureau | $170 | 94% |
| Wc One Call Medical | $170 | 94% |
| Wc Paradigm | $170 | 94% |
| Wc Peerless | $170 | 94% |
| Wc Pma | $170 | 94% |
| Wc Praxis Health Network | $170 | 94% |
| Wc Price Chopper | $170 | 94% |
| Wc Procura Management | $170 | 94% |
| Wc Qualcare | $170 | 94% |
| Wc Quiktrip | $170 | 94% |
| Wc Reny Company | $170 | 94% |
| Wc Rev Claims | $170 | 94% |
| Wc Risico | $170 | 94% |
| Wc Rural Mutual | $170 | 94% |
| Wc Saif Oregon | $170 | 94% |
| Wc Secura | $170 | 94% |
| Wc Sedgwick | $170 | 94% |
| Wc Sentry | $170 | 94% |
| Wc Sheakley Unicomp | $170 | 94% |
| Wc Smile Lodge | $170 | 94% |
| Wc Society | $170 | 94% |
| Wc Srs | $170 | 94% |
| Wc Taconic (Mro) | $170 | 94% |
| Wc Taconic Farms | $170 | 94% |
| Wc Travelers | $170 | 94% |
| Wc Triad Group | $170 | 94% |
| Wc Tristar | $170 | 94% |
| Wc Troy Ny | $170 | 94% |
| Wc Tyson | $170 | 94% |
| Wc Unified Health Services | $170 | 94% |
| Wc United Heartland | $170 | 94% |
| Wc Us Dept Of Labor | $170 | 94% |
| Wc Velocity | $170 | 94% |
| Wc Walmart | $170 | 94% |
| Wc West Bend | $170 | 94% |
| Wc West Bend Mutual/Argent | $170 | 94% |
| Wc Winnebago Industries | $170 | 94% |
| Wc Yankee Trails | $170 | 94% |
| Wc York Risk | $170 | 94% |
| Wc Zenith | $170 | 94% |
| Wc Zurich | $170 | 94% |
| Christian Brother Services | $178 | 98% |
| Meritain | $178 | 98% |
| Preferred One | $178 | 98% |
| Provider Partners Health Plan Of Indiana | $187 | 103% |
| Bcn Domestic | $202 | 111% |
| Blue Benefit Administrators Of Massachusetts | $202 | 111% |
| Blue Care Network | $202 | 111% |
| Blue Distinction Transplant | $202 | 111% |
| Blue Shield - Ca | $202 | 111% |
| Blue Shield - Id (Regence) | $202 | 111% |
| Blue Shield - Ny Highmark Northeastern | $202 | 111% |
| Blue Shield - Ny Highmark Western | $202 | 111% |
| Blue Shield - Pa (Highmark) | $202 | 111% |
| Blue Shield - Wa (Regence) | $202 | 111% |
| Health Choices | $202 | 111% |
| Kaiser Domestic | $202 | 111% |
| Pre-Employment | $202 | 111% |
| Wc Domestic | $202 | 111% |
| Ameriben | $218 | 120% |
| Caresource | $221 | 122% |
| Geha | $239 | 132% |
| Community Health Alliance | $266 | 147% |
| Phcs | $328 | 181% |
| Allied Benefit Systems | $362 | 200% |
| Auxiant | $362 - $364 | 200% |
| Benefit Administrative Systems,Llc | $362 | 200% |
| Custom Design Benefits | $362 | 200% |
| Encore Health | $362 - $364 | 200% |
| Key Benefit Administrator | $362 | 200% |
| Luminare Health (Detroit) | $362 | 200% |
| Physicians Health Plan Northern Indiana Health Insurance | $362 | 200% |
| Plain Church Group | $364 | 201% |
| Sagamore Health Network | $364 | 201% |
| Signature Care | $364 | 201% |
| Wc Encore Health Network | $364 | 201% |