CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Fairview Bethesda Hospital

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90791
Insurance Median: $508
Cash Discount Price: $365
vs. Medicare Baseline: 2.80x Medicare

The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Fairview Bethesda Hospital is $508. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $365. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 2.80x the Medicare baseline. Located in 45 10Th St W, Saint Paul, MN.

Cash / Self-Pay

$365

Average discount available for prompt cash payment at this facility.

Insurance Median

$508

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: $365 (201%)

Insurance Median: $508 (280%)

Cash: $365 (201% of Medicare)

Ins. Median: $508 (280% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 280% of the Medicare baseline (a markup of 180%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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	$112 - $386	62%
Medica	$122 - $662	67%
Health Partners	$125 - $713	69%
Itasca Medical Care	$125 - $160	69%
Primewest	$125 - $160	69%
South Country Health Alliance	$125 - $160	69%
Blue Cross Blue Shield	$131 - $540	72%
Sanford Health Plan	$139 - $540	77%
Security Health Plan	$139 - $687	77%
UnitedHealthcare	$139 - $523	77%
Wellcare	$139 - $160	77%
Hennepin Health	$141 - $162	78%
America'S Ppo	$370 - $660	204%
First Health	$582 - $751	321%
Multiplan	$604 - $779	333%
Private Healthcare Systems	$604 - $779	333%
Wisconsin Physician Services	$639 - $824	352%

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 $365.
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 Fairview Bethesda Hospital 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.