Psychiatric evaluation (first visit)
Facility: Osborne County Memorial Hospital
Billing Code: 90791 (CPT)
- CPT Billing Code: 90791
- Insurance Median: $237
- Cash Discount Price: $223
- vs. Medicare Baseline: 1.31x 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 | $199 | 110% |
| Health Partners Of Kansas | $225 | 124% |
| Wppa | $249 | 137% |
| Blue Cross Blue Shield | $257 | 142% |
Consumer Guidance & Cost Commentary
For this psychiatric evaluation at Osborne County Memorial Hospital, the cash price of $223.00 is notably lower than the negotiated rates charged to UnitedHealthcare ($199), Health Partners Of Kansas ($225), Wppa ($249), and Blue Cross Blue Shield ($257). While the cash rate is the lowest option listed, patients with high-deductible plans should verify if their specific insurance deductible has been met, as paying the full negotiated amount upfront could result in higher out-of-pocket costs than the cash price. It is important to note that commercial negotiated rates often include administrative overhead and contract dynamics that can inflate the baseline price, making the direct cash rate an attractive alternative for those without active insurance coverage.
The facility's cash price of $223.00 is also compared against the Medicare benchmark of $181.34, showing a markup factor of 1.3. This comparison highlights that while the cash rate exceeds the Medicare amount, it remains significantly below the full chargemaster gross of $262.00. To ensure you receive the most accurate pricing, we recommend contacting the hospital directly to confirm if "self-pay" or "prompt-pay" discounts are available, as these programs can further reduce the final amount owed. Additionally, if you have received a bill, always request a detailed, itemized statement to review specific CPT codes and avoid paying for services that were not rendered or that have been incorrectly bundled.