CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: St Charles Madras

Billing Code: 90791 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$269

about 1.5× the $181 Medicare rate · typically $209–$384

modeled estimate · not a bill or quote

What this hospital charges insurers

$264

About the fair price

about $5 under the fair price · 1.5× Medicare

Medicare pays $181 Fair price $269 This hospital $264 Cash price $282 Hospital's list price $352

How we calculate the fair BaseRate →

How this hospital compares to other OR hospitals

Highest price of the 9 OR hospitals we have prices for — worth calling around.

Cheapest $153 Priciest $264

Black dot = this hospital, among the 9 OR hospitals with a price for this procedure. Full list below.

A fair price for a Psychiatric evaluation (first visit) is about $269 (about 1.5× the $181 Medicare rate). St Charles Madras charges insurers about $264, or about $282 in cash — about the fair price. Located in Madras, OR.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

6 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana✓ Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$84 - $987	46%
Blue Cross Blue Shieldmajor	$93 - $522	51%
Aetnamajor	$84 - $929	46%
Cignamajor	$84 - $673	46%
Humanamajor	$84 - $256	46%
Kaiser Permanentemajor	$74 - $925	41%
Devoted Health	$84 - $256	46%
Health Net	$84 - $1,004	46%
Moda Health	$155 - $918	85%
PacificSource	$141 - $584	78%
Providence Health Plan	$126 - $934	69%
UniCare	$84 - $256	46%
WellCare	$84 - $256	46%
+ 64 smaller / regional plans	$74 - $1,068

Government programs also on file: Medicare, Medicaid, Military & VA.

Excludes 5 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 282), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 90791.

Insurance Before you use insurance

Call your insurance company to confirm St Charles Madras is in-network.
Ask your insurer whether prior approval is required for CPT code 90791.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at St Charles Madras

Compare: Psychiatric evaluation (first visit) at other OR hospitals

Insurance negotiated median for the same procedure, sorted lowest first.