Psychiatric evaluation (first visit)
Facility: Fredonia Regional Hospital
Billing Code: 90791 (CPT)
- CPT Billing Code: 90791
- Insurance Median: $145
- Cash Discount Price: $161
- vs. Medicare Baseline: 0.80x 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 | $129 - $404 | 71% |
| UnitedHealthcare | $136 - $145 | 75% |
| Aetna | $136 - $145 | 75% |
| Veterans Programs - All Plans | $136 | 75% |
| Meritain-All Plans | $145 | 80% |
| Reserve National-All Plans | $145 | 80% |
| Cigna | $145 | 80% |
Consumer Guidance & Cost Commentary
For the psychiatric evaluation (first visit) at Fredonia Regional Hospital in Fredonia, KS, the cash price is $161.00, which matches the facility's median negotiated rate of $145.00 and the cash median. This service is billed under CPT code 90791, and while the facility is a Critical Access Hospital owned by the local government, the data does not provide a specific county or state average for comparison. Patients should note that the cash price is identical to the negotiated rate, meaning there is no additional discount available for paying out-of-pocket compared to the standard commercial rate. Additionally, the facility's cash price is 80% of the Medicare amount of $181.34, indicating a markup relative to the federal benchmark.
Because the cash price equals the negotiated rate, patients with high-deductible plans may find paying the full $161.00 upfront to be the most cost-effective option, as they would avoid any potential deductibles or copays associated with insurance claims. It is important to verify if the facility offers "self-pay" or "prompt-pay" discounts before scheduling, as these upfront incentives can sometimes reduce the final bill further. If a patient receives an itemized bill, they should request a full line-by-line audit to ensure no errors or unbundled codes are present, as over 80% of hospital bills contain mistakes. Finally, while the No Surprises Act protects against balance billing for out-of-network providers at in-network facilities, patients should still confirm their plan's specific coverage details to avoid unexpected costs.