CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Wooster Community Hospital

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90791
  • Insurance Median: $247
  • Cash Discount Price: $309
  • vs. Medicare Baseline: 1.36x Medicare
The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Wooster Community Hospital is $247. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $309. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.36x the Medicare baseline. Located in 1761 Beall Avenue, Wooster, OH.
Cash / Self-Pay
$309

Average discount available for prompt cash payment at this facility.

Insurance Median
$247

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: $309 (170%)
Insurance Median: $247 (136%)
Cash: $309 (170% of Medicare)
Ins. Median: $247 (136% 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
Aultcare/Primecare Mcr Adv $151 83%
Buckeye Mcaid-All Other Plans $151 83%
Caresource Mcaid $151 83%
UnitedHealthcare $151 - $294 83%
Molina Mcaid $155 85%
Blue Cross Blue Shield $156 - $284 86%
Aetna $159 - $309 88%
Amerihealth Mcaid-All Plans $159 88%
Tricare $168 93%
Buckeye Mcare $172 95%
Caresource Mcr Adv $172 95%
Humana $172 - $291 95%
Med Mutual Of Oh Mcr $172 95%
Molina Mcr $172 95%
Summacare Mcr $172 95%
The Health Plan Mcr Adv $172 95%
Valor Hp Mcr-All Plans $172 95%
Healthsmart Complete Ppo-All Other Plans $195 108%
Cerco-All Plans $216 119%
Magnipower-All Plans $223 123%
Aultcare Wayne County $232 128%
Aultcare/Primetime Exch $232 128%
Rayco-All Plans $232 128%
Caresource Exch - All Other Plans $245 135%
Christian Health Ministries-All Plans $247 136%
Cigna $247 136%
Health Ohio Network Employer $247 136%
Wayne County-All Plans $247 136%
Healthsmart Accel $257 142%
Summacare Preferred Choice $257 142%
Health Ohio Network Ppo-All Other Plans $263 145%
Ohio Health Choice Supp $263 145%
Ohio Health Group Hlthy - All Other Plans $263 145%
Med Mutual Of Oh Exchange $266 147%
Med Mutual Of Oh Supermed $266 147%
Med Mutual Of Oh Trad-All Other Plans $266 147%
Health Plan Of Upper Ohio-All Plans $272 150%
The Health Plan Comm - All Other Plans $272 150%
Ohio Health Group Pref $275 152%
Aultcare/Primetime-All Other Plans $278 153%
Healthsmart Ppo $281 155%
Summacare-All Other Plans $287 158%
Ohio Health Choice-All Other Plans $291 160%
Molina Marketplace - All Other Plans $292 161%
Healthsmart Hpo $294 162%
Osu-All Plans $294 162%
Central Benefits-All Plans $297 164%
First Health-All Plans $297 164%
Flora-All Plans $297 164%
Beech Street-All Plans $300 165%
Phcs-All Plans $300 165%
Clarity Health - All Plans $335 185%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1761 Beall Avenue, Wooster, OH 44691
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals