Psychiatric evaluation (first visit)
Facility: Saint John Hospital
Billing Code: 90791 (CPT)
- CPT Billing Code: 90791
- Insurance Median: $176
- Cash Discount Price: $167
- vs. Medicare Baseline: 0.97x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| UnitedHealthcare | $167 - $234 | 92% |
| Midland Care Connection | $167 | 92% |
| Aetna | $167 | 92% |
| Cigna | $167 | 92% |
| Tricare | $167 | 92% |
| Medicare (plans) | $167 | 92% |
| Kansas Superior Select | $171 | 94% |
| Healthy Blue | $176 | 97% |
| Celtic | $176 - $268 | 97% |
| Comp Alliance Workers Comp | $208 | 115% |
| Oha Networks | $225 | 124% |
| Worker Compensation | $232 | 128% |
| Employer Direct Healthcare | $234 | 129% |
| Well Path | $234 | 129% |
| Corizon | $234 | 129% |
| Centurion | $251 | 138% |
| Naphcare | $259 | 143% |
Consumer Guidance & Cost Commentary
For this psychiatric evaluation at Saint John Hospital in Leavenworth, KS, the cash price of $167 is the lowest amount a patient could pay without insurance. While the facility's negotiated rates with major payers like UnitedHealthcare and Midland Care Connection range from $167 to $234, these amounts are often higher than the cash price due to administrative costs and contract structures. If you have a high-deductible plan, paying the cash price of $167 upfront might be more cost-effective than your insurance covering a negotiated rate that exceeds this amount, especially if your deductible has not yet been met. Patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as paying in full within a specific window can sometimes reduce the final bill further.
The facility's pricing is benchmarked against Medicare, which sets a fixed rate of $181.34 for this service. The cash price of $167 is slightly lower than the Medicare amount, illustrating that commercial negotiated rates can vary significantly based on payer contracts. It is important to note that while the No Surprises Act protects patients from balance billing for emergency care at in-network facilities, unexpected charges can still occur if ancillary services like labs or emergency physicians are out-of-network. To avoid these surprises, patients should request a detailed, itemized bill before paying, as summary invoices often hide unbundled codes or services not rendered. Disputing any errors in writing with the billing supervisor is the most effective way to ensure the final charge reflects only the actual care provided.