CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Pawhuska Hospital, Inc

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90791
  • Insurance Median: $163
  • Cash Discount Price: $136
  • vs. Medicare Baseline: 0.90x Medicare
The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Pawhuska Hospital, Inc is $163. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $136. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 0.90x the Medicare baseline. Located in 1101 East 15Th Street, Pawhuska, OK.
Cash / Self-Pay
$136

Average discount available for prompt cash payment at this facility.

Insurance Median
$163

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: $136 (75%)
Insurance Median: $163 (90%)
Cash: $136 (75% of Medicare)
Ins. Median: $163 (90% 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 - $166 75%
Humana $136 - $606 75%
Indian Nation Profee Only - All Plans $136 75%
Tricare $136 75%
UnitedHealthcare $136 - $140 75%
Wellcare Mcr Adv - All Plans $136 75%
Cigna $143 79%
Healthcare Highways - All Plans $143 79%
Evolutions Choice Ntwrk Profee Only - All Other Pl $150 83%
Aetna $154 - $606 85%
Community Care Comm - All Plans $163 90%
Evolutions Select/Adv Ntwrk Profee Only $163 90%
Ambetter / Centene $170 94%
Healthsmart Accel - Terminated $170 94%
Healthsmart Ppo/Pos - Terminated $184 101%
Galaxy Health Ntwk - Terminated $424 234%
Multiplan - All Plans $454 250%
Fpn-Fortified Prov Ntwrk Profee Only - All Plans $485 267%
Healthsmart Hpo - Terminated $485 267%
Soonerselect Mcaid - All Plans $606 334%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1101 East 15Th Street, Pawhuska, OK 74056
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals