CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Bluffton Regional Medical Center

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90791
  • Insurance Median: $188
  • Cash Discount Price: $108
  • vs. Medicare Baseline: 1.04x Medicare
The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Bluffton Regional Medical Center is $188. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $108. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.04x the Medicare baseline. Located in 303 S Main St, Bluffton, IN.
Cash / Self-Pay
$108

Average discount available for prompt cash payment at this facility.

Insurance Median
$188

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: $108 (60%)
Insurance Median: $188 (104%)
Cash: $108 (60% of Medicare)
Ins. Median: $188 (104% 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
Amish Aid $60 - $79 33%
Physicians Health Plan $60 - $80 33%
Self Pay $60 - $182 33%
Lutheran Preferred Network $74 - $282 41%
Php Freedom Network $78 - $104 43%
Cigna $79 - $117 44%
Php $79 - $105 44%
Aetna $90 - $185 50%
Php Management Systems $96 - $128 53%
Lutheran Trma $100 - $149 55%
UnitedHealthcare $117 - $188 65%
Encore Ppo $122 - $162 67%
Sagamore Sebt $127 - $169 70%
Sagamore Health Newtork Inc $133 - $177 73%
Consumer Life $154 - $205 85%
Ahg Dana Employees $162 - $215 89%
Veterans Eval Services $162 89%
Align Networks $174 - $232 96%
Blue Cross Blue Shield $185 - $772 102%
Medicare (plans) $185 102%
Node Iu Health Mcr Adv $185 102%
Node Mhs Mcr Adv $185 102%
Prime Health Services $187 - $338 103%
Private Healthcare Systems Inc $187 - $248 103%
Humana $188 104%
Node Caresource Mcr Adv $188 104%
Node Devoted Health Mcr Adv $188 104%
Node Non Par Hospice Agree $188 104%
Node Va $188 104%
Northeast Hospice $188 104%
County Jail Health Care $195 108%
In Dept Of Correction $195 108%
Node Pphp Mcr Adv $197 109%
Multiplan $199 - $265 110%
Encore Health Network $204 - $298 112%
Advantage 360 $207 - $275 114%
Community Health Alliance $212 - $281 117%
First Health $214 - $285 118%
Allied Benefit Systems $224 - $298 124%
Cardinal Health Alliance $224 - $298 124%
Ppom $224 - $298 124%
Us Department Of Labor $235 130%
Lutheran Advanced Network $282 156%
Lutheran Three Rivers Preferred Plus 150 $282 156%
Lutheran Three Rivers Preferred Plus 175 $329 181%
Encore Work Comp In $338 186%
Lutheran Northwest Health Preferred $376 207%
Managed Health Services Exchange $376 207%
Workers Compensation $376 207%
Encore Kba Epo $451 249%
Encore Kba Ppo $563 310%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 303 S Main St, Bluffton, IN 46714
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals