CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Phelps Memorial Health Center

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90791
  • Insurance Median: $201
  • Cash Discount Price: $299
  • vs. Medicare Baseline: 1.11x Medicare
The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Phelps Memorial Health Center is $201. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $299. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.11x the Medicare baseline. Located in 1215 Tibbals St, Holdrege, NE.
Cash / Self-Pay
$299

Average discount available for prompt cash payment at this facility.

Insurance Median
$201

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: $299 (165%)
Insurance Median: $201 (111%)
Cash: $299 (165% of Medicare)
Ins. Median: $201 (111% 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
Blue Cross Blue Shield $136 - $241 75%
Good Samaritan Mcr Adv - All Plans $136 75%
Medica Mcr Adv $136 75%
UnitedHealthcare $136 - $332 75%
Va Ccn - All Plans $136 75%
Wellcare Mcr Adv - All Plans $136 75%
Three Rivers - All Plans $163 90%
Aetna $172 - $332 95%
Providrs Care/Wppa - All Plans $176 97%
Provider Network Of American - All Plans $204 112%
Partners Hlth Alliance - All Plans $238 131%
6 Degrees Hlth - All Plans $245 135%
Medica-All Other Plans $245 135%
Midwest Ntwrk Alliance - All Plans $259 143%
Ambetter / Centene $262 144%
First Health - All Plans $316 174%
Molina Mcaid - All Plans $332 183%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1215 Tibbals St, Holdrege, NE 68949
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals