CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Prosser Memorial Hospital

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90791
Insurance Median: $165
Cash Discount Price: $195
vs. Medicare Baseline: 0.91x Medicare

The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Prosser Memorial Hospital is $165. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $195. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 0.91x the Medicare baseline. Located in 723 Memorial Street, Prosser, WA.

Cash / Self-Pay

$195

Average discount available for prompt cash payment at this facility.

Insurance Median

$165

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: $195 (108%)

Insurance Median: $165 (91%)

Cash: $195 (108% of Medicare)

Ins. Median: $165 (91% 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
Community Health Plan Of Washington	$75 - $165	41%
Coordinated Care	$75 - $143	41%
Kaiser Permanente	$75 - $731	41%
UnitedHealthcare	$75 - $283	41%
Molina	$79 - $165	44%
Amerigroup	$80 - $152	44%
Health Alliance Northwest	$88 - $165	49%
Wellcare	$88 - $165	49%
Humana	$89 - $301	49%
Aetna	$106 - $301	58%
Cigna	$148 - $290	82%
Premera	$176 - $283	97%
Asuris	$178 - $319	98%
Health Management Adminstrators	$178 - $319	98%
Regence	$178 - $319	98%
Ambetter / Centene	$248 - $298	137%
First Choice	$301	166%
Multiplan	$301 - $319	166%

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 $195.
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 Prosser Memorial 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.