CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Astera Health

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90791
Insurance Median: $158
Cash Discount Price: $304
vs. Medicare Baseline: 0.87x Medicare

The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Astera Health is $158. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $304. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 0.87x the Medicare baseline. Located in 421 11Th Street Nw, Wadena, MN.

Cash / Self-Pay

$304

Average discount available for prompt cash payment at this facility.

Insurance Median

$158

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: $304 (168%)

Insurance Median: $158 (87%)

Cash: $304 (168% of Medicare)

Ins. Median: $158 (87% 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
Sanford Health Plan [10120]	$68 - $76	37%
Blue Plus Pmap [40002]	$84 - $166	46%
Ucare Pmap [30006]	$95 - $128	52%
Health Partners Pmap [10046]	$117	65%
Medica Pmap [10057]	$117	65%
Primewest Pmap [30003]	$117	65%
Health Partners [10045]	$121 - $166	67%
UnitedHealthcare	$138 - $163	76%
Blue Cross Blue Shield	$158 - $327	87%
Medica Nonpmap [10056]	$158 - $33,502	87%
Primewest Non Pmap [30004]	$158 - $166	87%
Ucare Non Pmap [30007]	$158 - $166	87%
Ucare Commercial [10705]	$320	176%
Multiplan	$344	190%
Aetna	$387	213%

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 $304.
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 Astera Health 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.