CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Astria Toppenish Hospital

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90791
  • Insurance Median: $234
  • Cash Discount Price: $183
  • vs. Medicare Baseline: 1.29x Medicare
The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Astria Toppenish Hospital is $234. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $183. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.29x the Medicare baseline. Located in 502 W Fourth Ave, Toppenish, WA.
Cash / Self-Pay
$183

Average discount available for prompt cash payment at this facility.

Insurance Median
$234

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: $183 (101%)
Insurance Median: $234 (129%)
Cash: $183 (101% of Medicare)
Ins. Median: $234 (129% 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 $43 - $285 24%
Premera_Affordable_Care $106 58%
Li $142 78%
Aetna $163 - $247 90%
Cigna $163 90%
Humana $163 - $281 90%
Medicare (plans) $163 - $244 90%
Tricare $163 90%
Zenith $164 90%
Chpw_Cascade_Care $177 98%
First_Choice $194 107%
Tpsc $219 121%
UnitedHealthcare $232 - $237 128%
Ambetter / Centene $237 131%
Molina $241 133%
Bcchp $281 155%
Great_Rivers $281 155%
Healthcomp $281 155%
Washington_State_Hca $281 155%
Molina_Exchange $308 170%
Va $397 219%
Kaiser $543 299%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 502 W Fourth Ave, Toppenish, WA 98948
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals