CMS Price Transparency Data
Psychiatric evaluation (first visit)
Facility: St Charles Madras
Billing Code: 90791 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 90791
- Insurance Median: $264
- Cash Discount Price: $282
- vs. Medicare Baseline: 1.46x Medicare
The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at St Charles Madras is $264. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $282. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.46x the Medicare baseline. Located in 470 Ne A Street, Madras, OR.
Cash / Self-Pay
$282
Average discount available for prompt cash payment at this facility.
Insurance Median
$264
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: $282 (156%)
Insurance Median: $264 (146%)
Cash: $282 (156% of Medicare)
Ins. Median: $264 (146% 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
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Advanced Health [534] | $74 - $438 | 41% |
| Allcare Health Plan [538] | $74 - $438 | 41% |
| Cascade Health Alliance [532] | $74 - $438 | 41% |
| Columbia Pacific Coordinated Care Llc [539] | $74 - $438 | 41% |
| Health Share Care Oregon [526] | $74 - $438 | 41% |
| Health Share Kaiser [543] | $74 - $438 | 41% |
| Health Share Ohsu Ohp [552] | $74 - $438 | 41% |
| Health Share Providence [548] | $74 - $438 | 41% |
| Health Share [537] | $74 - $438 | 41% |
| Intercommunity Health [530] | $74 - $438 | 41% |
| Jackson Care Connect [542] | $74 - $438 | 41% |
| Medicaid / KanCare | $74 - $438 | 41% |
| Primary Health Of Jospehine County Llc [547] | $74 - $438 | 41% |
| Umpqua Health [533] | $74 - $438 | 41% |
| Willamette Valley Community Health [536] | $74 - $438 | 41% |
| Yamhill County Coordinated Care Org [550] | $74 - $438 | 41% |
| Aetna | $84 - $929 | 46% |
| Ageright Advantage [142] | $84 - $256 | 46% |
| Champ Va [700] | $84 - $256 | 46% |
| Cigna | $84 - $673 | 46% |
| Covid19 Hrsa Uninsured Testing And Treatment Fund | $84 - $256 | 46% |
| Devoted Health Inc [145] | $84 - $256 | 46% |
| Health Market Care Assured [134] | $84 - $256 | 46% |
| Health Net Med Adv [135] | $84 - $256 | 46% |
| Humana | $84 - $256 | 46% |
| Indian Health [704] | $84 - $256 | 46% |
| Kaiser Permanente Med Adv [136] | $84 - $256 | 46% |
| Law Enforcement [701] | $84 - $530 | 46% |
| Medicare (plans) | $84 - $297 | 46% |
| Samaritan Health Plan Med Adv [141] | $84 - $256 | 46% |
| Unicare [133] | $84 - $256 | 46% |
| UnitedHealthcare | $84 - $987 | 46% |
| Veterans [706] | $84 - $256 | 46% |
| Wellcare [132] | $84 - $256 | 46% |
| Blue Cross Blue Shield | $93 - $522 | 51% |
| Tricare | $110 - $333 | 61% |
| Us Benefits [326] | $113 - $673 | 62% |
| Providence Health Plan [347] | $126 - $934 | 69% |
| Pacificsource [345] | $141 - $584 | 78% |
| Rocky Mountain Administrators [405] | $144 - $854 | 79% |
| Rx Internal [4100003] | $147 - $872 | 81% |
| Moda [310] | $155 - $918 | 85% |
| First Choice Health [317] | $156 - $925 | 86% |
| Kaiser Permanente [334] | $156 - $925 | 86% |
| Samaritan [376] | $156 - $925 | 86% |
| Meritain Health [300] | $157 - $929 | 87% |
| Health Net [340] | $169 - $1,004 | 93% |
| Administrative Concepts Inc [402] | $176 - $1,046 | 97% |
| First Health [339] | $176 - $1,046 | 97% |
| Manhattan Life Insurance Company [379] | $176 - $1,046 | 97% |
| Philadelphia American Life Insurance Company [395] | $176 - $1,046 | 97% |
| Planned Administrators Inc [375] | $176 - $1,046 | 97% |
| Auto Allstate Insurance [602] | $264 - $1,068 | 146% |
| Auto American Family Insurance [603] | $264 - $1,068 | 146% |
| Auto Country Insurance Claims [604] | $264 - $1,068 | 146% |
| Auto Dairyland Insurance [617] | $264 - $1,068 | 146% |
| Auto Farmers [605] | $264 - $1,068 | 146% |
| Auto Geico Claims Oregon [606] | $264 - $1,068 | 146% |
| Auto Hartford [612] | $264 - $1,068 | 146% |
| Auto Liberty Mutual Auto Ins [613] | $264 - $1,068 | 146% |
| Auto Mutual Of Enumclaw [610] | $264 - $1,068 | 146% |
| Auto Nationwide Allied Insuranc [601] | $264 - $1,068 | 146% |
| Auto Oregon Mutual [614] | $264 - $1,068 | 146% |
| Auto Progressive [608] | $264 - $1,068 | 146% |
| Auto Safeco Concentra [600] | $264 - $1,068 | 146% |
| Auto State Farm Claims [609] | $264 - $1,068 | 146% |
| Auto Sublimity Insurance [616] | $264 - $1,068 | 146% |
| Auto Travelers Insurance [615] | $264 - $1,068 | 146% |
| Auto Usaa [611] | $264 - $1,068 | 146% |
| Generic Auto [649] | $264 - $1,068 | 146% |
| Generic Workers Comp [699] | $264 - $1,068 | 146% |
| Otj Broadspire Services [670] | $264 - $1,068 | 146% |
| Otj Ccmsi [618] | $264 - $1,068 | 146% |
| Otj Chartis Claims [650] | $264 - $1,068 | 146% |
| Otj City County Ins Services [662] | $264 - $1,068 | 146% |
| Otj Corvel [676] | $264 - $1,068 | 146% |
| Otj Esis West Wc Claims [653] | $264 - $1,068 | 146% |
| Otj Gallagher Bassett [654] | $264 - $1,068 | 146% |
| Otj Hartford [655] | $264 - $1,068 | 146% |
| Otj Intermountain Claims Inc [666] | $264 - $1,068 | 146% |
| Otj Liberty Mutual Wausau Underwriters [671] | $264 - $1,068 | 146% |
| Otj Penser No American [663] | $264 - $1,068 | 146% |
| Otj Pinnacle Risk Mgmt [661] | $264 - $1,068 | 146% |
| Otj Saif [667] | $264 - $1,068 | 146% |
| Otj Sedgwick Cms [660] | $264 - $1,068 | 146% |
| Otj Sedgwick [668] | $264 - $1,068 | 146% |
| Otj Travelers Insurance [672] | $264 - $1,068 | 146% |
| Otj Tristar [673] | $264 - $1,068 | 146% |
| Bridgespan [342] | $443 | 244% |
| Asuris Northwest Health [202] | $522 | 288% |
| Healthcare Management Admin [201] | $522 | 288% |
| Regence Group Administrators [203] | $522 | 288% |