CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Kosciusko Community Hospital

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90791
  • Insurance Median: $195
  • Cash Discount Price: $83
  • vs. Medicare Baseline: 1.08x Medicare
The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Kosciusko Community Hospital is $195. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $83. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.08x the Medicare baseline. Located in 2101 E Dubois Dr, Warsaw, IN.
Cash / Self-Pay
$83

Average discount available for prompt cash payment at this facility.

Insurance Median
$195

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: $83 (46%)
Insurance Median: $195 (108%)
Cash: $83 (46% of Medicare)
Ins. Median: $195 (108% 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 $52 - $70 29%
Self Pay $52 - $129 29%
Lutheran Preferred Network $79 - $265 44%
Physicians Health Plan $92 - $153 51%
Php Freedom Network $96 - $128 53%
UnitedHealthcare $97 - $201 53%
Encore $100 - $132 55%
Trma Inc $100 - $149 55%
Aetna $102 - $198 56%
One Call Care Diagnostics Wc $136 75%
Connecticut General Life Insurance Company $147 - $195 81%
Cigna $157 - $209 87%
Veterans Eval Services $162 89%
First Health Network $187 - $248 103%
Prime Health Services $187 - $362 103%
Blue Cross Blue Shield $198 - $772 109%
Humana $198 109%
Medicare (plans) $198 109%
Mhs $198 109%
Iu Health $201 111%
Node Non Par Hospice Agree $201 111%
Node Va $201 111%
Node Devoted Health Mcr Adv $202 111%
Advantage Health $207 - $275 114%
In Dept Of Correction $209 115%
Node Pphp Mcr Adv $211 116%
Private Healthcare Systems $214 - $285 118%
Sagamore $219 - $311 121%
Encore Health Network $232 - $308 128%
Us Department Of Labor $251 138%
Lutheran Advanced Network $302 167%
Lutheran Preferred $302 - $402 167%
Align In Work Comp $322 178%
One Call Work Comp $322 178%
Encore Work Comp In $362 200%
Managed Health Services Exchange $402 222%
Workers Comp $402 222%
Encore Kba Epo $483 266%
Encore Kba Ppo $603 333%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2101 E Dubois Dr, Warsaw, IN 46580
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals