CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Roundup Memorial Healthcare

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90791
Insurance Median: $276
Cash Discount Price: $285
vs. Medicare Baseline: 1.52x Medicare

The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Roundup Memorial Healthcare is $276. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $285. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.52x the Medicare baseline. Located in 1202 3Rd St W, Roundup, MT.

Cash / Self-Pay

$285

Average discount available for prompt cash payment at this facility.

Insurance Median

$276

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: $285 (157%)

Insurance Median: $276 (152%)

Cash: $285 (157% of Medicare)

Ins. Median: $276 (152% 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
Geha-All Plans	$234	129%
Tricare	$253	140%
Blue Cross Blue Shield	$256 - $285	141%
Ebms (Rmhn Network) - All Plans	$271	149%
Pacific Source-All Plans	$271	149%
First Choice-All Plans	$276	152%
Montana Health Co-Op Ppo/Pos - All Plans	$276	152%
Multiplan-All Plans	$276	152%
Va Ccn - All Plans	$526	290%

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 $285.
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 Roundup Memorial Healthcare 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.