CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: St Charles Medical Center - Bend

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90791
Insurance Median: $863
Cash Discount Price: $854
vs. Medicare Baseline: 4.76x Medicare

The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at St Charles Medical Center - Bend is $863. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $854. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 4.76x the Medicare baseline. Located in 2500 Ne Neff Road, Bend, OR.

Cash / Self-Pay

$854

Average discount available for prompt cash payment at this facility.

Insurance Median

$863

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: $854 (471%)

Insurance Median: $863 (476%)

Cash: $854 (471% of Medicare)

Ins. Median: $863 (476% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 476% of the Medicare baseline (a markup of 376%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Tricare	$142	78%
Medicaid / KanCare	$208	115%
Generic Workers Comp [699]	$369	203%
Otj Broadspire Services [670]	$369	203%
Otj Ccmsi [618]	$369	203%
Otj Chartis Claims [650]	$369	203%
Otj City County Ins Services [662]	$369	203%
Otj Corvel [676]	$369	203%
Otj Esis West Wc Claims [653]	$369	203%
Otj Gallagher Bassett [654]	$369	203%
Otj Hartford [655]	$369	203%
Otj Intermountain Claims Inc [666]	$369	203%
Otj Liberty Mutual Wausau Underwriters [671]	$369	203%
Otj Penser No American [663]	$369	203%
Otj Pinnacle Risk Mgmt [661]	$369	203%
Otj Saif [659]	$369	203%
Otj Saif [667]	$369	203%
Otj Sedgwick Cms [660]	$369	203%
Otj Sedgwick [668]	$369	203%
Otj Travelers Insurance [672]	$369	203%
Otj Tristar [673]	$369	203%
Pacificsource [345]	$427 - $584	235%
Blue Cross Blue Shield	$443 - $522	244%
Bridgespan [342]	$443	244%
Asuris Northwest Health [202]	$522	288%
Healthcare Management Admin [201]	$522	288%
Regence Group Administrators [203]	$522	288%
Law Enforcement [701]	$530	292%
Cigna	$673	371%
Us Benefits [326]	$673	371%
Providence Health Plan [347]	$747 - $934	412%
Rocky Mountain Administrators [405]	$854	471%
Rx Internal [4100003]	$872	481%
Moda [310]	$918	506%
First Choice Health [317]	$925	510%
Kaiser Permanente [334]	$925	510%
Samaritan [376]	$925	510%
Aetna	$929	512%
Meritain Health [300]	$929	512%
Auto Allstate Insurance [602]	$961	530%
Auto American Family Insurance [603]	$961	530%
Auto Country Insurance Claims [604]	$961	530%
Auto Dairyland Insurance [617]	$961	530%
Auto Farmers [605]	$961	530%
Auto Geico Claims Oregon [606]	$961	530%
Auto Hartford [612]	$961	530%
Auto Liberty Mutual Auto Ins [613]	$961	530%
Auto Mutual Of Enumclaw [610]	$961	530%
Auto Nationwide Allied Insuranc [601]	$961	530%
Auto Oregon Mutual [614]	$961	530%
Auto Progressive [608]	$961	530%
Auto Safeco Concentra [600]	$961	530%
Auto State Farm Claims [609]	$961	530%
Auto Sublimity Insurance [616]	$961	530%
Auto Travelers Insurance [615]	$961	530%
Auto Usaa [611]	$961	530%
Generic Auto [649]	$961	530%
UnitedHealthcare	$987	544%
Health Net [340]	$1,004	554%
Administrative Concepts Inc [402]	$1,046	577%
First Health [339]	$1,046	577%
Manhattan Life Insurance Company [379]	$1,046	577%
Philadelphia American Life Insurance Company [395]	$1,046	577%
Planned Administrators Inc [375]	$1,046	577%

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 $854.
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 St Charles Medical Center - Bend 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.