CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Black River Memorial Hospital

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90791
Insurance Median: $150
Cash Discount Price: $202
vs. Medicare Baseline: 0.83x Medicare

The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Black River Memorial Hospital is $150. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $202. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 0.83x the Medicare baseline. Located in 711 W Adams St, Black River Falls, WI.

Cash / Self-Pay

$202

Average discount available for prompt cash payment at this facility.

Insurance Median

$150

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: $202 (111%)

Insurance Median: $150 (83%)

Cash: $202 (111% of Medicare)

Ins. Median: $150 (83% 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
Blue Cross Blue Shield	$72 - $197	40%
Group Health Cooperative Of Eau Claire	$72 - $325	40%
Inclusa	$72 - $156	40%
Managed Health Services Insurance Corp	$72 - $156	40%
My Choice Wisconsin, Inc.	$72 - $156	40%
Quartz Health Solutions, Inc	$72 - $305	40%
UnitedHealthcare	$72 - $325	40%
Security Health Plan	$83 - $281	46%
The Alliance	$83 - $285	46%
Humana	$114 - $312	63%
Corvel	$137 - $204	76%
Triology Health Solutions	$202 - $318	111%
Medica	$209 - $313	115%
Association Benefits Solution	$213 - $318	117%
Family Health Center Of Marshfield	$213 - $318	117%
First Health Group Corporation	$213 - $318	117%
Provider Network Of America	$213 - $318	117%
Cigna	$217 - $325	120%
Cofinity	$217 - $325	120%
Coventry Health Care	$217 - $325	120%
Custom Benefit Administrators	$217 - $325	120%
Healthpartners, Inc.	$217 - $325	120%
Multiplan	$217 - $325	120%
Wisconsin Physicians Service Insurance Corp	$217 - $325	120%
Chorus	$220 - $328	121%

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 $202.
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 Black River 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.