Psychiatric evaluation (first visit)
Facility: Wesley Medical Center
Billing Code: 90791 (CPT)
- CPT Billing Code: 90791
- Insurance Median: $187
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 1.03x 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 |
|---|---|---|
| Blue Cross Blue Shield | $187 | 103% |
Consumer Guidance & Cost Commentary
For a psychiatric evaluation at Wesley Medical Center in Wichita, KS, the negotiated rate of $187 aligns exactly with the Medicare benchmark of $181.34, indicating a markup of 100% versus the federal baseline. This facility is the sole payer for this service in the region, with no variation across the two Blue Cross Blue Shield plans. While cash-pay options are not currently listed for this specific code, patients should be aware that cash rates can sometimes be lower than insurance negotiated rates, particularly for those with high-deductible plans. It is advisable to contact the hospital directly to inquire about self-pay or prompt-pay discounts, which could reduce the final amount owed if you choose to pay upfront.
When reviewing your final invoice, ensure you receive an itemized bill that breaks down every CPT code and unit cost, as summary bills often obscure individual charges. Since over 80% of hospital bills contain errors, requesting a detailed statement is the most effective way to identify unbundled services or charges for items not rendered. If you encounter discrepancies, dispute them in writing rather than relying on verbal assurances from customer service. Additionally, remember that while the No Surprises Act protects you from balance billing for out-of-network providers at in-network facilities, you should still verify your deductible status before scheduling to avoid unexpected out-of-pocket costs.