Psychiatric evaluation (first visit)
Facility: Kiowa District Hospital
Billing Code: 90791 (CPT)
- CPT Billing Code: 90791
- Insurance Median: $236
- Cash Discount Price: $200
- vs. Medicare Baseline: 1.30x 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 | $98 | 54% |
| Blue Cross Blue Shield | $168 | 93% |
| UnitedHealthcare | $200 - $250 | 110% |
| Health Partners Of Ks-All Plans | $220 | 121% |
| Humana | $226 | 125% |
| Healthchoice-All Plans | $230 | 127% |
| Multiplan-All Plans | $235 | 130% |
| Gbs Insurance - All Plans | $235 | 130% |
| Medicare (plans) | $238 | 131% |
| Triwest-All Plans | $238 | 131% |
| Aetna | $238 | 131% |
| Medicaid / KanCare | $250 | 138% |
| Providers Care (Wppa)-All Plans | $375 | 207% |
| Liberty Healthshare-All Plans | $404 | 223% |
Consumer Guidance & Cost Commentary
For the psychiatric evaluation (first visit) at Kiowa District Hospital in Kiowa, KS, the facility's cash price of $200.00 is lower than the median negotiated rate of $235.00 paid by most insurers. While the gross charge listed is $250.00, patients with high-deductible plans may find paying the cash price directly more cost-effective than relying on insurance, as the negotiated rates for major payers like UnitedHealthcare and Health Partners Of Ks-All Plans range from $200.00 to $250.00. Because this facility is a Critical Access Hospital owned by a Government Hospital District, patients should proactively ask about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront fee reductions can bypass the administrative overhead that often inflates insurance billing cycles.
The Medicare benchmark for this service is $181.34, which serves as a reliable baseline for evaluating the facility's pricing markup rather than the inflated gross charge. Although the facility's cash rate of $200.00 is slightly higher than the Medicare amount, it remains below the median negotiated rate of $236.00 observed across the 14 payer plans listed, including Tricare and Blue Cross Blue Shield. Consumers should be aware that balance billing is generally prohibited for emergency care and non-emergency services at in-network facilities under the No Surprises Act, but if unexpected charges arise, patients should request an itemized billing audit to identify errors such as code unbundling or services not rendered, as over 80% of hospital bills contain inaccuracies that can be corrected through formal written disputes.