CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Sky Lakes Medical Center

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90791
Insurance Median: $175
Cash Discount Price: $131
vs. Medicare Baseline: 0.97x Medicare

The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Sky Lakes Medical Center is $175. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $131. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 0.97x the Medicare baseline. Located in 2865 Daggett Avenue, Klamath Falls, OR.

Cash / Self-Pay

$131

Average discount available for prompt cash payment at this facility.

Insurance Median

$175

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: $131 (72%)

Insurance Median: $175 (97%)

Cash: $131 (72% of Medicare)

Ins. Median: $175 (97% 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
Moda Health [1070]	$144 - $175	79%
Pacificsource Health Plan PPO [1072]	$157	87%
Pacificsource [1195]	$157	87%
First Choice Health PPO [1220]	$175	97%
International Benefit Administrator [1172]	$175	97%
Veterans Administration [4004]	$175	97%
State Farm [6027]	$175	97%
Healthscope [1126]	$175	97%
Kaiser Permanente Hawaii [3050]	$175	97%
Travelers Insurance Oregon Mva [6050]	$175	97%
Albertson [1004]	$175	97%
Screenwise Program [5017]	$175	97%
United American Ins [1097]	$175	97%
American National [1178]	$175	97%
Country Companies [6008]	$175	97%
Mailhandlers Benefit [1062]	$175	97%
Allied Benefit Systems [1158]	$175	97%
Medico Insurance Company [1194]	$175	97%
Sanford Health Plan [1147]	$175	97%
Claims Administrator Lucent Health [1188]	$175	97%
Phillips Admin Service [1073]	$175	97%
Cco Health Share OHSU [5041]	$175	97%
Kaiser Permanente [1056]	$175	97%
Tribal Health Coquille [1088]	$175	97%
Health Now Admin Services [1120]	$175	97%
Managed Care Administrators [1128]	$175	97%
Uct Insurance [1094]	$175	97%
Providence Hospice [1050]	$175	97%
Plexis Healthcare Systems [1246]	$175	97%
Iac [1157]	$175	97%
Chartis [6006]	$175	97%
Esis [6047]	$175	97%
Medicare (plans)	$175	97%
Cco Yamhill Community Care Org [5032]	$175	97%
UnitedHealthcare	$175	97%
Rsl Specialty Products Admin [1131]	$175	97%
Cigna	$175	97%
Kaiser Permanente [3047]	$175	97%
Champva [4001]	$175	97%
Samaritan Health Plan [3043]	$175	97%
Cco Health Share Kaiser [5031]	$175	97%
Us Family Health Plan [4007]	$175	97%
Asante Hospice [1048]	$175	97%
Enumclaw Property & Casualty [6045]	$175	97%
Cco Columbia Pacific [5026]	$175	97%
Fra Ins Plans [1035]	$175	97%
Eob Tpa LLC [1250]	$175	97%
Kaiser of Washington [1207]	$175	97%
Cco Health Share Tuality [5028]	$175	97%
Josephine County [6030]	$175	97%
Ohp Doctors of Oregon Coast So [5007]	$175	97%
Healthpartners [1192]	$175	97%
United Teacher Assoc Ins Co [1171]	$175	97%
Cco Intercommunity Health Network [5010]	$175	97%
Saif [6022]	$175	97%
S&S Health Tpa PPO [1219]	$175	97%
North America Administrators [1174]	$175	97%
Western Benefits [1101]	$175	97%
Combined Insurance [1106]	$175	97%
Bakery and Confectionery Union [1119]	$175	97%
Mvp Select Care [1140]	$175	97%
Veterans Evaluation Services [4008]	$175	97%
Medi Cal [5002]	$175	97%
Medicaid / KanCare	$175	97%
Standard Life and Accident Ins [1167]	$175	97%
Shasta Administrators [1092]	$175	97%
State Farm Health [1084]	$175	97%
Liberty Health Plan [1057]	$175	97%
Avma Health Group 1St Hlth PPO [1016]	$175	97%
State Mutual Insurance Company [1173]	$175	97%
Claimsbridge Ath01 [1254]	$175	97%
Transamerica Life Ins [1087]	$175	97%
Kemper Auto [3062]	$175	97%
Gravie Administrative Services [1249]	$175	97%
Mba Benefit Administrators [1253]	$175	97%
Crawford and Co [6009]	$175	97%
Verdegard Administrators LLC [1204]	$175	97%
Specialty Risk Solutions [6025]	$175	97%
Mutual of Omaha [1068]	$175	97%
Operating Engineers [1071]	$175	97%
Zurich North America - Claims [6058]	$175	97%
Boilermaker Natl Hlth and Wlfr [1020]	$175	97%
Tantara [1110]	$175	97%
Healthnet PPO [1047]	$175	97%
The General [3055]	$175	97%
Triwest [4006]	$175	97%
Cas Tpa [1210]	$175	97%
Travelers Insurance Oregon Wc [6035]	$175	97%
Kaiser Northern California HMO [1223]	$175	97%
Globe Life and Accident Ins Co [1177]	$175	97%
University of Utah Health Plans [1212]	$175	97%
Continental Benefits [1196]	$175	97%
Western Growers Assurance Trust [3053]	$175	97%
Progressive Auto [6020]	$175	97%
American Family Auto [3033]	$175	97%
Aig Workers Compensation [6000]	$175	97%
So Ca Drug Benefit Fund [1133]	$175	97%
Oregon Mutual Insurance Co [6019]	$175	97%
Web Tpa [1170]	$175	97%
Standard Life [1169]	$175	97%
Sierra Health and Life [1200]	$175	97%
Broadspire [6034]	$175	97%
Coordinated Benefit Plans [1124]	$175	97%
Ag Specialty Insurance [1242]	$175	97%
Teamsters Food Employers Med Supp [1239]	$175	97%
Sublimity Insurance [6028]	$175	97%
Cco Trillium Community Health Plan [5011]	$175	97%
Alaska Electrical [1003]	$175	97%
Blue Cross Blue Shield	$175 - $609	97%
Office Workers Com [6018]	$175	97%
Cco Umpqua Health Alliance [5008]	$175	97%
Samba [1082]	$175	97%
Dairyland Auto Ins [6010]	$175	97%
Usaa Auto Insurance [3048]	$175	97%
Motion Picture Health [1066]	$175	97%
Healthcare Management Admin [1109]	$175	97%
Allcare Medigap [1162]	$175	97%
Ohp Marion Polk Comm Health Pl [5012]	$175	97%
Geha [1038]	$175	97%
Alaska Teamster [1116]	$175	97%
Mega Life and Hlth [1065]	$175	97%
Liberty Mutual [6049]	$175	97%
Zenith Admin [1104]	$175	97%
Ilwu Pma Welfare Plan [1053]	$175	97%
Trustmark [1209]	$175	97%
Tcc of South Carolina [1135]	$175	97%
National General Accident Health [1202]	$175	97%
Argo Group Us Wc Claims [6002]	$175	97%
Intermountain Claims [6014]	$175	97%
Pyramid Life Insurance [1080]	$175	97%
Cco Jackson Care Connect [5005]	$175	97%
Cco Allcare Health Plan [5013]	$175	97%
Wausau Ins [1100]	$175	97%
Cco Pacifisource Community Sol [5016]	$175	97%
Nationwide Ins [3051]	$175	97%
Amshield [6057]	$175	97%
Sedgwick Cms [6023]	$175	97%
Bridgespan Health [1213]	$175	97%
Lineco Ins First Health [1059]	$175	97%
Harrington Benefit Services [1043]	$175	97%
Imagine 360 [1251]	$175	97%
Union Pacific Rr Emp Health [1096]	$175	97%
State Comp of Ca [6026]	$175	97%
Ohp Newborn Pending Id [8006]	$175	97%
Blue Shield Covered California [1241]	$175	97%
Lifewise Tpm Trust [1058]	$175	97%
Principal Life Insurance [1077]	$175	97%
Cypress Benefit Administrators [1179]	$175	97%
Kaiser Covered California [5035]	$175	97%
Aither Health Plan [1243]	$175	97%
Cna Workers Compensation [6056]	$175	97%
Loomis [1060]	$175	97%
Oregon State Police [8004]	$175	97%
Cco Health Share Oregon [5030]	$175	97%
Sentinel Security Life Insurance [1189]	$175	97%
Ameriben Solutions [1007]	$175	97%
Us Department of Labor [6011]	$175	97%
Meritain Health [1129]	$175	97%
Nonstop Wellness [3044]	$175	97%
Special District Assoc of Or [6024]	$175	97%
Greater Oregon Behavioral Hlth [5001]	$175	97%
Crime Victims Comp Program [8002]	$175	97%
Safeco [6021]	$175	97%
Hartford Auto Insurance [3049]	$175	97%
Cannon Cochran Mgmt [6005]	$175	97%
Gpa [1193]	$175	97%
Bs of Ca Promise Health Plan [5039]	$175	97%
Teamsters Benefit Trust [1190]	$175	97%
Central States Idemnity Med Supp [1143]	$175	97%
Geico [6032]	$175	97%
Gallagher Bassett [6013]	$175	97%
Us Department of Labor [6036]	$175	97%
Allstate Mva [6001]	$175	97%
Hartford [6015]	$175	97%
Nationwide Worker's Comp [3032]	$175	97%
Washington National Ins [1099]	$175	97%
Contra Costa Health [5038]	$175	97%
Tribal Health Klamath [1091]	$175	97%
Tricare	$175	97%
Connecticut General Life [1122]	$175	97%
Farmers Ins Medical [1033]	$175	97%
Lucent Health [1187]	$175	97%
Auic Org [1118]	$175	97%
Teamsters Food Employers Sec [1136]	$175	97%
Root Insurance Company [6048]	$175	97%
Corvel [3066]	$175	97%
Joint Labor Mgmt Retail Trust [1055]	$175	97%
Woodmen Life Supplement [1248]	$175	97%
National Guardian Life [1208]	$175	97%
Iec Benefit Administrators [1052]	$175	97%
Asuris Northwest Health [1117]	$175	97%
Managed Hlth Netwrk Bh Healthnet [1233]	$175	97%
Farmers Insurance [6012]	$175	97%
Construction Teamsters [1123]	$175	97%
Providence Health Ph & S Oregon [3036]	$175	97%
Physicians Mutual Ins [1074]	$175	97%
Pemco Mutual Insurance [6044]	$175	97%
Aetna	$175	97%
Plumbing and Pipefitting Trst [1076]	$175	97%
Asante Moda Health Plan [1245]	$175	97%
Sbma [1252]	$175	97%
Partnership Healthplan of Ca [5033]	$175	97%
Bristol Hospice [1206]	$175	97%
Western Teamsters Welfare [1103]	$175	97%
Covered California [5040]	$175	97%
G and G Electric Healthcare Plan [1036]	$175	97%
Blue Shield Out of State PPO [1235]	$175	97%
Arkansas Walmart Claims Mgmt [6003]	$175	97%
Tristar Insurance Group [6042]	$175	97%
Providence Health Assur Med Supp [1079]	$175	97%
Masters Mates and Pilots [1063]	$175	97%
Zurich Farmers [6029]	$175	97%
Sky Lakes Health Plan [1156]	$175	97%
Pai [1130]	$175	97%
Lumico Life Insurance [1183]	$175	97%
Jackson County [8003]	$175	97%
Deseret Mutual Mhn [1030]	$175	97%
Options for Southern Oregon [5022]	$175	97%
Pioneer Life [1075]	$175	97%
UPMC Health Plan [1228]	$175	97%
Mediplus Troa Claims [1064]	$175	97%
Cambridge Integrated Service [6004]	$175	97%
Delta Health System [1107]	$175	97%
Plumbers and Pipefitters Union [1083]	$175	97%
Personify Health [1125]	$175	97%
Mba Merchants Benefit Admin [1247]	$175	97%
Healthnet Med Supp [1149]	$175	97%
State of Oregon [5019]	$175	97%
Select Health Plan PPO [1132]	$175	97%
Us Marshals Office [8005]	$175	97%
Tribal Health Karuk [1090]	$175	97%
Transamerica Gap Supplement [1186]	$175	97%
Starr Indemnity and Liability [1134]	$175	97%
Wells Fargo Insurance Services [1139]	$175	97%
Liberty Mutual [6016]	$175	97%
Providence Health Plan Bh [1205]	$175	97%
Cco Advanced Health [5027]	$175	97%
Ebms [1031]	$175	97%
Equitable [1032]	$175	97%
City County Ins Service [6007]	$175	97%
Usaa Ins [1098]	$175	97%
Ufcw [1095]	$175	97%
Washington Dept of Labor & Ind [6051]	$175	97%
Humana	$175	97%
United Indian Health Services [1211]	$175	97%
Met Life Mva [3045]	$175	97%
Cco Eastern Oregon [5023]	$175	97%
Thrivent Financial [1176]	$175	97%
Careassist Program/Tpa [1165]	$175	97%
Matrix Absence Management Inc [6038]	$175	97%
Aflac Med Supp [1234]	$175	97%

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 $131.
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 Sky Lakes Medical Center 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.