CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Independence Health System Butler Memorial Hospita

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90791
  • Insurance Median: $174
  • Cash Discount Price: $247
  • vs. Medicare Baseline: 0.96x Medicare
The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Independence Health System Butler Memorial Hospita is $174. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $247. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 0.96x the Medicare baseline. Located in One Hospital Way, Butler, PA.
Cash / Self-Pay
$247

Average discount available for prompt cash payment at this facility.

Insurance Median
$174

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: $247 (136%)
Insurance Median: $174 (96%)
Cash: $247 (136% of Medicare)
Ins. Median: $174 (96% 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
Medicaid / KanCare $26 14%
UnitedHealthcare $26 - $396 14%
Amerihealth $29 - $162 16%
Geisinger $29 - $353 16%
Jefferson Health Plan $29 16%
Gateway $30 - $371 17%
Upmc $30 - $371 17%
Highmark $66 - $326 36%
Highmark - Ind.& Managed Care $66 - $362 36%
Highmark Aca - Direct Blue $66 - $204 36%
Highmark Community Blue $66 - $320 36%
Behavioral $85 47%
Ellwood Group $106 - $309 58%
Martin'S Point - Usfhp $124 - $155 68%
Workers Comp $139 77%
Devoted Health Plan $141 - $164 78%
Life Butler County $155 85%
Medicare (plans) $155 85%
Peak Health $155 - $363 85%
Provider Partners $155 85%
Tricare $155 85%
Aetna $159 - $356 88%
Humana $161 89%
The Health Plan $164 - $363 90%
Pa Health & Wellness $165 91%
American Health Plan $170 94%
Pnoa $170 - $282 94%
Ccbh - Behavioral Health $176 97%
Cigna $176 - $353 97%
Private Healthcare Systems $247 - $300 136%
Devon $265 146%
Intergroup $282 156%
Multiplan $318 175%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: One Hospital Way, Butler, PA 16001
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals