CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Yoakum Community Hospital

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90791
Insurance Median: $161
Cash Discount Price: $140
vs. Medicare Baseline: 0.89x Medicare

The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Yoakum Community Hospital is $161. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $140. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 0.89x the Medicare baseline. Located in 1200 Carl Ramert Drive, Yoakum, TX.

Cash / Self-Pay

$140

Average discount available for prompt cash payment at this facility.

Insurance Median

$161

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: $140 (77%)

Insurance Median: $161 (89%)

Cash: $140 (77% of Medicare)

Ins. Median: $161 (89% 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.

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
Humana	$88	49%
Medicare (plans)	$88	49%
Prime Health Svcs Mcr Advantage	$88	49%
Scott & White Mcare Advan	$88	49%
Superior Mcr Advantage	$88	49%
Triwest Va Ccn-All Plans	$88	49%
Tx Independent Hp Mcr Advantage-All Plans	$88	49%
UnitedHealthcare	$88 - $156	49%
Blue Cross Blue Shield	$89 - $161	49%
Superior Hix-All Other Plans	$110	61%
Kempton Group Admin Ppo-All Plans	$141	78%
Entrust - All Plans	$150	83%
Medicaid / KanCare	$156 - $215	86%
Amera-Net-All Plans	$161	89%
Phcs Multiplan - All Plans	$161	89%
Scott & White Ppo-All Other Plans	$161	89%
Healthsmart Ppo-All Other Plans	$168	93%
Blue Bell Creameries Emp-All Plans	$172	95%
Cigna	$172	95%
Americas Health Plan-All Plans	$183	101%
Beech Street-All Plans	$183	101%
Directcare America-All Plans	$183	101%
Galaxy Ppo - All Plans	$183	101%
Health Star Comm Ip/Op Only - All Plans	$183	101%
Medcorp Southwest Ppo-All Plans	$183	101%
Medical Control Ppo-All Plans	$183	101%
Aetna	$194	107%
Healthsmart Work Comp	$194	107%
Prime Health Svcs Ppo-All Other Plans	$194	107%

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 $140.
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 Yoakum Community Hospital 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.