CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Sanford Behavioral Health Center

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90791
Insurance Median: $337
Cash Discount Price: $376
vs. Medicare Baseline: 1.86x Medicare

The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Sanford Behavioral Health Center is $337. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $376. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.86x the Medicare baseline. Located in 120 Labree Avenue South, Thief River Falls, MN.

Cash / Self-Pay

$376

Average discount available for prompt cash payment at this facility.

Insurance Median

$337

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: $376 (207%)

Insurance Median: $337 (186%)

Cash: $376 (207% of Medicare)

Ins. Median: $337 (186% 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
Blue Cross Blue Shield	$138 - $372	76%
Sanford Health Plan Align	$153 - $204	84%
Ucare	$164 - $473	90%
Aetna	$166 - $468	92%
Health Partners	$166 - $436	92%
Medicare (plans)	$166 - $222	92%
UnitedHealthcare	$166 - $449	92%
Primewest	$169 - $226	93%
Sanford Health Plan	$215 - $339	119%
Security Health Plan	$221 - $296	122%
Medica	$353 - $509	195%
Cigna	$362 - $484	200%
First Choice Health Network	$362 - $484	200%
Healthez	$362 - $484	200%
Multiplan	$362 - $484	200%

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 $376.
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 Sanford Behavioral Health 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.