CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Cambridge Medical Center

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90791
Insurance Median: $208
Cash Discount Price: $187
vs. Medicare Baseline: 1.15x Medicare

The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Cambridge Medical Center is $208. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $187. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.15x the Medicare baseline. Located in 701 South Dellwood Avenue, Cambridge, MN.

Cash / Self-Pay

$187

Average discount available for prompt cash payment at this facility.

Insurance Median

$208

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$181.34

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $181.34 (100%)

Cash / Self-Pay: $187 (103%)

Insurance Median: $208 (115%)

Cash: $187 (103% of Medicare)

Ins. Median: $208 (115% of 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Ucare Pmap (A B C D E G N O S U R H)	$40 - $121	22%
Aetna	$89 - $358	49%
Medica Health System	$102 - $485	56%
Healthpartners	$136 - $407	75%
Medica Ubh (D)	$140 - $421	77%
Health Partners	$148 - $444	82%
Americas Ppo (Araz)(B D N O R S V)	$155 - $464	85%
Americas Ppo (Araz) (B D N H O R S)	$169 - $506	93%
First Health (A C E G H U B D N O R S)	$169 - $506	93%
Medicaid / KanCare	$169	93%
Hennepin Health	$174	96%
Medicare (plans)	$183	101%
Medica	$190	105%
Blue Cross Blue Shield	$192 - $983	106%
Scha Msho (D)	$200	110%
All Other Contracted Care (A B C D E G H N O R S U)	$201 - $602	111%
UnitedHealthcare	$674	372%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $187.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 90791.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Cambridge Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 90791.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.