Psychiatric evaluation (first visit)
Facility: Amberwell Atchison Association
Billing Code: 90791 (CPT)
- CPT Billing Code: 90791
- Insurance Median: $215
- Cash Discount Price: $420
- vs. Medicare Baseline: 1.19x 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 |
|---|---|---|
| Va Ccn - All Plans | $139 | 77% |
| Humana | $139 - $189 | 77% |
| UnitedHealthcare | $139 - $754 | 77% |
| Superior Select Mcr Adv - All Plans | $139 | 77% |
| Triwest - All Plans | $139 | 77% |
| Blue Cross Blue Shield | $161 - $169 | 89% |
| Ambetter / Centene | $215 | 119% |
| Cigna | $231 | 127% |
| Aetna | $231 | 127% |
| Centrus Health Direct - All Plans | $315 | 174% |
| Oscar - All Plans | $315 | 174% |
| Multiplan - All Plans | $328 | 181% |
| Wppa Providrs Care - All Plans | $378 | 208% |
Consumer Guidance & Cost Commentary
For the CPT code 90791, representing a psychiatric evaluation at Amberwell Atchison Association in Atchison, KS, the cash price is $420.00, which matches the facility's median negotiated rate. This cash price is significantly higher than the state average for this service, which is $223.00. While commercial insurance plans like Humana and UnitedHealthcare negotiate rates ranging from $139 to $754, these amounts often exceed the cash price, meaning patients with high-deductible plans might save money by paying out-of-pocket and then seeking prompt-pay discounts. It is important to note that the facility's cash rate is 1.2 times the Medicare benchmark of $181.34, indicating a markup relative to the federal baseline used for cost transparency.
Patients should be aware that balance billing is generally prohibited for emergency services under the No Surprises Act, but unexpected charges can still occur if ancillary services are out-of-network. To avoid these surprises, consumers should request an itemized billing audit before payment to ensure no unbundled codes or services not rendered are included in the final invoice. Additionally, while the facility is a voluntary non-profit Critical Access Hospital, patients should explicitly ask about self-pay or prompt-pay discounts prior to scheduling, as these upfront fee reductions can lower the total cost significantly compared to the standard cash price. Always verify your specific plan's deductible status and allowed amounts before accepting insurance coverage to ensure you are not paying the full negotiated rate.