CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Essentia Health St Joseph's Medical Center

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90791
  • Insurance Median: $173
  • Cash Discount Price: $234
  • vs. Medicare Baseline: 0.95x Medicare
The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Essentia Health St Joseph's Medical Center is $173. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $234. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 0.95x the Medicare baseline. Located in 523 North 3Rd Street, Brainerd, MN.
Cash / Self-Pay
$234

Average discount available for prompt cash payment at this facility.

Insurance Median
$173

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: $234 (129%)
Insurance Median: $173 (95%)
Cash: $234 (129% of Medicare)
Ins. Median: $173 (95% 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.

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
Medica Access $71 - $119 39%
Healthpartners Care Pmap $96 - $162 53%
Sanford Health Plan $96 - $170 53%
Blue Cross Blue Shield $101 - $589 56%
Blue Plus Pmap Pcc Prime $101 - $552 56%
Medica $142 - $266 78%
Medica Uplan $142 - $239 78%
Ucare $147 - $247 81%
Primewest $154 85%
Itasca Med Care $161 89%
Wea $161 - $290 89%
Medica Choice $163 - $274 90%
Cigna $165 - $276 91%
Healthpartners $165 - $276 91%
Healthpartners Pcc Prime $165 - $276 91%
UnitedHealthcare $170 - $286 94%
Advocare/Security Health $173 95%
Freedom Blue Ppo $173 95%
Healthpartners Care Msho / Mcr Adv $173 95%
Imcare Msho Pcc Prime $173 95%
Imcare Msho Ref Req $173 95%
Medica Advantage Solutions $173 95%
Medica Msho/Dual Solutions $173 95%
Medica Prime Solution Group $173 95%
Medicare (plans) $173 95%
Nd Va Administration $173 95%
Platinum Blue/Vantage Blue $173 95%
Primewest Msho $173 95%
Secure Blue Msho $173 95%
Ubh Cost Plan $173 95%
Ubh Msho $173 95%
Ucare Msho $173 95%
America'S Ppo $174 - $291 96%
Wps $186 - $316 103%
Aetna $190 - $320 105%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 523 North 3Rd Street, Brainerd, MN 56401
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals