CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Marshfield Medical Center - Beaver Dam (Mmc-Bd)

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90791
  • Insurance Median: $171
  • Cash Discount Price: $219
  • vs. Medicare Baseline: 0.94x Medicare
The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Marshfield Medical Center - Beaver Dam (Mmc-Bd) is $171. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $219. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 0.94x the Medicare baseline. Located in 707 S University Ave, Beaver Dam, WI.
Cash / Self-Pay
$219

Average discount available for prompt cash payment at this facility.

Insurance Median
$171

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: $219 (121%)
Insurance Median: $171 (94%)
Cash: $219 (121% of Medicare)
Ins. Median: $171 (94% 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
The Alliance $117 65%
Security Health Plan (Shp) $120 - $153 66%
Amish/Mennonite $127 70%
Quartz $132 - $153 73%
Blue Cross Blue Shield $143 - $171 79%
Humana $153 - $206 84%
Managed Health Services $153 84%
Molina Healthcare Of Wi $153 - $196 84%
Network Health Plan $153 - $193 84%
UnitedHealthcare $153 - $173 84%
Veteran'S Administration (Va Ccn) $153 84%
Wps Health Insurance $155 85%
Cigna $157 - $171 87%
Health Payment Systems $161 89%
Group Health Cooperative Of Eau Claire $162 - $219 89%
Icare $164 90%
First Health $196 108%
Trilogy $208 115%
Healtheos By Multiplan Inc. $215 - $219 119%
Health Partners $219 121%
Coventry $222 122%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 707 S University Ave, Beaver Dam, WI 53916
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals