Psychiatric evaluation (first visit)
Facility: Centura St. Catherine-Dodge City
Billing Code: 90791 (CPT)
- CPT Billing Code: 90791
- Insurance Median: $140
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.77x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Medicare (plans) | $140 | 77% |
| Kansas Health | $140 | 77% |
| Cigna | $140 | 77% |
| Humana | $140 | 77% |
| Blue Cross Blue Shield | $140 - $199 | 77% |
| Aetna | $140 | 77% |
| Kaiser | $140 | 77% |
Consumer Guidance & Cost Commentary
For the CPT code 90791, representing a psychiatric evaluation at Centura St. Catherine-Dodge City, the negotiated rates across seven payers range from $140 to $199, with a median negotiated amount of $140. This aligns closely with the state of Kansas average, where the median paid is also $140. While the facility's Medicare benchmark is $181.34, commercial rates here are generally lower or equivalent to the federal baseline. It is important to note that while in-network insurance caps charges at these negotiated levels, patients with high-deductible plans might find the cash price to be more affordable if the insurance allowed amount exceeds the cash rate. Always verify the specific cash or self-pay rate with the hospital, as prompt-pay discounts may further reduce the final cost.
The facility is a proprietary acute care hospital located in Dodge City, KS, and while it holds a 3-star rating, the pricing data reflects standard commercial negotiations rather than outlier markups. Commercial rates for this service typically average between 200% and 300% of the Medicare amount, though the $140 median here suggests a rate closer to the fair pricing range of 120% to 150% of the Medicare benchmark. If you receive an itemized bill later, ensure it breaks down specific CPT codes to avoid errors such as unbundling or charges for services not rendered. Remember that the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, so any unexpected charges should be disputed immediately with the insurer rather than paid in full.