CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Forks Community Hospital

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90791
Insurance Median: $142
Cash Discount Price: $238
vs. Medicare Baseline: 0.78x Medicare

The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Forks Community Hospital is $142. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $238. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 0.78x the Medicare baseline. Located in 530 Bogachiel Way, Forks, WA.

Cash / Self-Pay

$238

Average discount available for prompt cash payment at this facility.

Insurance Median

$142

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: $238 (131%)

Insurance Median: $142 (78%)

Cash: $238 (131% of Medicare)

Ins. Median: $142 (78% 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
Medicaid / KanCare	$103 - $110	57%
Coordinated Care (Mco) Mcd-All Plans	$104 - $111	57%
UnitedHealthcare	$104 - $193	57%
Cigna	$120 - $336	66%
Community Health Network Mcr-All Other Plans	$134 - $160	74%
Humana	$134 - $139	74%
Tricare	$134 - $141	74%
Triwest-All Plans	$134 - $139	74%
Molina Commercial-All Other Plans	$139 - $274	77%
Va-Ihs - All Plans	$139	77%
Aetna	$142 - $399	78%
Regence-All Other Plans	$150 - $420	83%
Ambetter / Centene	$156 - $162	86%
Blue Cross Blue Shield	$156 - $283	86%
Wellcare Med Adv - All Plans	$156 - $162	86%
Medicare (plans)	$160 - $318	88%
First Choice-All Plans	$168 - $298	93%
Community Health Exchange	$188 - $194	104%

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 $238.
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 Forks 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.