CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: North Central Health Care

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90791
  • Insurance Median: $266
  • Cash Discount Price: $446
  • vs. Medicare Baseline: 1.47x Medicare
The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at North Central Health Care is $266. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $446. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.47x the Medicare baseline. Located in 1150 Lakeview Dr, Wausau, WI.
Cash / Self-Pay
$446

Average discount available for prompt cash payment at this facility.

Insurance Median
$266

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: $446 (246%)
Insurance Median: $266 (147%)
Cash: $446 (246% of Medicare)
Ins. Median: $266 (147% 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
Medicaid / KanCare $170 94%
Inclusa - Family Care Wps Insurance $205 113%
Blue Cross Blue Shield $262 - $266 144%
Medicare (plans) $262 144%
UnitedHealthcare $262 - $266 144%
Aetna $266 147%
All Savers $266 147%
Aspirus Health Plan $266 147%
Aspirus Health Plan - First Health Network $266 147%
Chorus Community Health Plan $266 147%
Dean Care $266 147%
Health Eos - Multiplan $266 147%
Lakeland Care District/Wps Insurance $266 147%
Medica Claims $266 147%
Molina $266 147%
The Alliance $266 147%
United Behavioral Health $266 147%
Group Health Cooperative $279 154%
Cenpatico $285 157%
Security Health Plan $291 160%
Security Health Plan - HMO $291 160%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1150 Lakeview Dr, Wausau, WI 54403
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Psychiatric