Psychiatric evaluation (first visit)
Facility: Mcpherson Hospital
Billing Code: 90791 (CPT)
- CPT Billing Code: 90791
- Insurance Median: $268
- Cash Discount Price: $259
- vs. Medicare Baseline: 1.48x 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 |
|---|---|---|
| Tricare | $144 | 79% |
| Healthy Blue Mcr Adv | $163 | 90% |
| Wellcare Mcr Adv - All Plans | $163 | 90% |
| UnitedHealthcare | $163 - $350 | 90% |
| Humana | $163 | 90% |
| Va Ccn - All Plans | $163 | 90% |
| Blue Cross Blue Shield | $163 | 90% |
| Ambetter / Centene | $188 | 104% |
| Wppa - All Plans | $245 | 135% |
| Central Plains - All Plans | $262 | 144% |
| Medical Associates - All Plans | $262 | 144% |
| Christian Health Aid - All Plans | $280 | 154% |
| Aetna | $289 - $350 | 159% |
| Multiplan - All Plans | $315 | 174% |
| First Health - All Plans | $332 | 183% |
| Cigna | $332 | 183% |
| Health Partners - All Plans | $332 | 183% |
| Medicaid / KanCare | $350 | 193% |
| Health Blue Mcaid - All Other Plans | $357 | 197% |
Consumer Guidance & Cost Commentary
For this psychiatric evaluation at McPherson Hospital in McPherson, Kansas, the facility's cash median rate of $259.00 is notably lower than the negotiated rates paid by most major insurers, which range from $163 to $350. While the facility's negotiated rate of $268.00 is slightly higher than the cash price, patients with high-deductible plans may find paying out-of-pocket initially more cost-effective, as the cash rate avoids the administrative overhead and markup inherent in insurance billing cycles. It is important to note that while the facility is an in-network provider for many plans, the actual amount paid by insurance varies significantly by carrier, with some plans like Tricare and Healthy Blue Mcr Adv paying exactly $144 and $163 respectively, whereas others like Aetna and UnitedHealthcare pay up to $350.
When evaluating the value of this service, the facility's cash rate of $259.00 is approximately 1.5 times the Medicare benchmark amount of $181.34, which serves as a scientifically validated baseline for healthcare costs. Although the facility is a voluntary non-profit acute care hospital, the wide variance in payer payments—from $144 for Tricare to $350 for Aetna—highlights that in-network status does not guarantee a uniform price. Consumers should be aware that hospitals often offer prompt-pay discounts for upfront cash payments, which can further reduce the final bill, and should always request an itemized statement to ensure no errors or unbundled charges are included before settling any balance.