CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: University of Wi Hospitals & Clinics Authority

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90791
  • Insurance Median: $185
  • Cash Discount Price: $170
  • vs. Medicare Baseline: 1.02x Medicare
The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at University of Wi Hospitals & Clinics Authority is $185. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $170. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.02x the Medicare baseline. Located in 600 Highland Avenue, Madison, WI.
Cash / Self-Pay
$170

Average discount available for prompt cash payment at this facility.

Insurance Median
$185

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: $170 (94%)
Insurance Median: $185 (102%)
Cash: $170 (94% of Medicare)
Ins. Median: $185 (102% 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
Blue Cross Blue Shield $67 - $389 37%
Alliance_Premier_Network $78 - $195 43%
Mercycare $81 - $203 45%
Triology $84 - $249 46%
Security_Health_Plan $89 - $260 49%
Employer'S_Coalition_On_Health $90 - $315 50%
Alliance $92 - $230 51%
Hfn $93 - $315 51%
United_Healthcare $94 - $347 52%
Beloit_Health_System $95 - $237 52%
Aspirus_Health_Plan $96 - $239 53%
Cigna $98 - $245 54%
Health_Partners_Insurance $100 - $249 55%
Health_Payment_Systems $101 - $251 56%
UnitedHealthcare $103 - $256 57%
Dean_Health_Plan $105 - $262 58%
Medical_Associates $108 - $270 60%
Wps $114 - $312 63%
Employers_Healthcare_Coalition_Of_Wi $115 - $286 63%
Aetna $117 - $328 65%
Aspirus_Network_Inc $126 - $315 69%
Chorus_Community $131 - $327 72%
Ghc_Eau_Claire_Health_Plan $131 - $327 72%
Multiplan $131 - $376 72%
Sheybogan_Employers_Health_Network $131 - $327 72%
Coventry $139 - $348 77%
Dean_Care $139 - $348 77%
Healthsmart $144 - $360 79%
Humana $181 100%
Medicare (plans) $181 - $185 100%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 600 Highland Avenue, Madison, WI 53792
  • CMS Rating: ★★★★★
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals