CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Porter-Starke Services Inc

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90791
  • Insurance Median: $93
  • Cash Discount Price: $209
  • vs. Medicare Baseline: 0.51x Medicare
The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Porter-Starke Services Inc is $93. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $209. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 0.51x the Medicare baseline. Located in 701 Wall St, Valparaiso, IN.
Cash / Self-Pay
$209

Average discount available for prompt cash payment at this facility.

Insurance Median
$93

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: $209 (115%)
Insurance Median: $93 (51%)
Cash: $209 (115% of Medicare)
Ins. Median: $93 (51% 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
Cigna $57 - $78 31%
Compsych $59 - $72 33%
Carelon Eap $60 33%
Compsych Eap $60 33%
United Behavioral Health $75 - $83 41%
UnitedHealthcare $75 - $124 41%
Ambetter / Centene $93 - $124 51%
Carelon $93 - $115 51%
Encore $93 - $124 51%
First Health $93 - $124 51%
Magellan $93 - $124 51%
Phcs/Multiplan $93 - $124 51%
Sagamore $93 - $124 51%
Humana $118 65%
Blue Cross Blue Shield $121 - $151 67%
Php $126 - $167 69%
Aetna $133 73%
Caresource Marketplace $156 86%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 701 Wall St, Valparaiso, IN 46383
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Psychiatric