CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: The Orthopaedic Hospital of Lutheran Health Networ

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90791
  • Insurance Median: $179
  • Cash Discount Price: $78
  • vs. Medicare Baseline: 0.99x Medicare
The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at The Orthopaedic Hospital of Lutheran Health Networ is $179. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $78. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 0.99x the Medicare baseline. Located in 7952 W Jefferson Blvd, Ft Wayne, IN.
Cash / Self-Pay
$78

Average discount available for prompt cash payment at this facility.

Insurance Median
$179

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: $78 (43%)
Insurance Median: $179 (99%)
Cash: $78 (43% of Medicare)
Ins. Median: $179 (99% 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
Physicians Health Plan $60 - $128 33%
Amish Aid $67 - $89 37%
Self Pay $67 - $89 37%
Lutheran Preferred $73 - $282 40%
Php Freedom Network $78 - $104 43%
Cigna $87 - $331 48%
Aetna $97 - $185 53%
Three Rivers Preferred $100 - $149 55%
Sagamore $120 - $179 66%
Encore Ppo $124 - $166 68%
UnitedHealthcare $166 - $188 92%
Multiplan $172 - $258 95%
One Call Work Comp $172 95%
Blue Cross Blue Shield $185 - $772 102%
Humana $185 102%
Iu Health Plan $185 102%
Medicare (plans) $185 102%
Node Mhs Mcr Adv $185 102%
Small Business Aid $185 102%
Prime Health Services $187 - $338 103%
Node Devoted Health Mcr Adv $188 104%
Node Hospice Non Par Agree $188 104%
Node Va $188 104%
Police And Sheriff $191 105%
First Health $192 - $255 106%
In Dept Of Correction $195 108%
Node Pphp Mcr Adv $197 109%
Encore $199 - $265 110%
Node Us Dept Of Labor $235 130%
Lutheran Advanced Network $282 156%
Node Lutheran Three Rivers Preferred Plus 150 $282 156%
Occunet In Work Comp $282 156%
Align Network $300 165%
Node Lutheran Three Rivers Preferred Plus 175 $329 181%
Encore Wc $338 186%
Medrisk In Work Comp $338 186%
Three Rivers Preferred In Work Comp $338 186%
Objective Surgical $366 202%
In Work Comp $376 207%
Lutheran Network $376 207%
Managed Health Services $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: 7952 W Jefferson Blvd, Ft Wayne, IN 46804
  • CMS Rating: No CMS Rating
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals