CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: St Marys Hospital Medical Ctr

Billing Code: 90791 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$166

about 0.9× the $181 Medicare rate · typically $148–$300

modeled estimate · not a bill or quote

What this hospital charges insurers

$173

About the fair price

about $7 over the fair price · 1.0× Medicare

Medicare pays $181 Fair price $166 This hospital $173 Cash price $380 Hospital's list price $575

How we calculate the fair BaseRate →

How this hospital compares to other WI hospitals

Highest price of the 9 WI hospitals we have prices for — worth calling around.

Cheapest $114 Priciest $173

Black dot = this hospital, among the 9 WI hospitals with a price for this procedure. Full list below.

A fair price for a Psychiatric evaluation (first visit) is about $166 (about 0.9× the $181 Medicare rate). St Marys Hospital Medical Ctr charges insurers about $173, or about $380 in cash — about the fair price. Located in Green Bay, WI.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$173 - $521	95%
Blue Cross Blue Shieldmajor	$110 - $391	61%
Aetnamajor	$173 - $575	95%
Cignamajor	$402	222%
Humanamajor	$173 - $489	95%
Health Net	$345	190%
Meridian	$110	61%
Molina	$116 - $288	64%
Security Health Plan	$175 - $367	97%
+ 16 smaller / regional plans	$110 - $575

Government programs also on file: Medicare, Medicaid.

Excludes 6 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 380), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 90791.

Insurance Before you use insurance

Call your insurance company to confirm St Marys Hospital Medical Ctr is in-network.
Ask your insurer whether prior approval is required for CPT code 90791.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at St Marys Hospital Medical Ctr

Compare: Psychiatric evaluation (first visit) at other WI hospitals

Insurance negotiated median for the same procedure, sorted lowest first.