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Psychiatric diagnostic evaluation

CPT 90791 · negotiated-rate distribution across hospitals in WI

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Hospitals
24
Min
$117.38
Median
$162.18
Max
$521.92
Range multiplier
4.4×

By payer (50 payers with published rates)

PayerHosp.RatesMinMedianMaxRange×
Anthem BCBS740$108.23$170.94$696.356.4×
Medicare1437$18.73$156.01$173.629.3×
UnitedHealthcare1033$18.55$183.00$521.9228.1×
VA Health1122$154.46$156.01$163.271.1×
Blue Cross Blue Shield420$18.20$150.54$422.4623.2×
Humana617$147.15$521.92$521.923.5×
aspirus115$67.39$162.39$439.076.5×
First Health515$45.00$314.10$433.809.6×
Molina714$152.81$324.37$344.102.3×
smart health714$218.41$218.41$228.581.0×
Cigna411$82.04$170.94$427.235.2×
Medicaid310$73.48$147.69$410.545.6×
network health plan68$98.79$192.88$250.942.5×
prevea 36018$140.14$384.19$623.054.4×
security health plan38$87.90$146.00$226.852.6×
wps77$440.50$440.50$440.501.0×
mercy care16$102.55$202.67$256.552.5×
Multiplan26$126.26$214.83$219.451.7×
group health cooperative of eau claire26$111.00$189.42$219.452.0×
medica [900156]36$150.78$305.49$346.382.3×
health partners35$108.23$152.81$219.452.0×
trilogy25$207.90$207.90$353.501.7×
security health plan (shp)15$120.07$133.43$153.151.3×
Aetna25$122.10$269.67$417.133.4×
ma wisconsin replacement [950271]25$185.00$386.00$425.002.3×
WellCare24$162.18$162.18$162.181.0×
healthpartners14$303.00$378.75$378.751.3×
health payment systems34$117.38$160.78$328.252.8×
smarthealth24$216.24$216.24$216.241.0×
quartz health insurance13$117.94$117.94$117.941.0×
alliance33$427.55$427.55$427.551.0×
common ground13$303.00$303.00$303.001.0×
froedtert health13$97.13$111.00$117.941.2×
healthpartners [900713]33$218.79$296.61$398.741.8×
quartz23$131.67$153.15$228.321.7×
wisconsin physician service13$313.10$328.25$328.251.0×
wps health plan13$105.45$117.94$124.881.2×
health partners open network12$196.93$232.02$267.101.4×
health eos plus12$303.00$303.00$303.001.0×
health eos12$404.00$404.00$404.001.0×
medical associates health plan12$263.44$432.32$601.202.3×
meridiancare12$147.15$151.17$155.191.1×
dean health plan12$111.00$111.00$111.001.0×
common ground healthcare cooperative12$104.06$111.00$117.941.1×
centivo nw322$476.78$476.78$476.781.0×
centivo nw122$476.78$476.78$476.781.0×
centivo22$108.23$243.49$378.753.5×
cchp22$310.31$310.31$310.311.0×
trilogy health solutions12$104.06$111.00$117.941.1×
unitedhealth group of wi12$153.15$163.09$173.021.1×

By hospital (top 200 by negotiated median, descending)

HospitalCitySTPayersGrossCashNeg minNeg medianNeg max
Ascension Sacred Heart RehabilitatioMilwaukeeWI4$183.00$521.92$521.92
Sheboygan Memorial HospitalSheboyganWI18$505.00$252.50$252.50$353.50$503.00
Ascension Columbia St Marys OzaukeeMequonWI7$864.00$457.92$156.41$344.10$521.92
Ascension Columbia St Marys MilwaukeMilwaukeeWI7$864.00$457.92$156.41$344.10$521.92
Meriter Hospital Inc.MadisonWI14$733.00$586.40$67.39$226.85$696.35
Beaver Dam Community HospitalsBeaver DamWI20$231.00$219.45$117.30$170.94$221.76
Westfields HospitalNew RichmondWI8$425.00$223.55$73.48$167.54$425.00
All Saints - St. Luke S HospitalRacineWI4$500.00$265.00$163.27$163.27$440.50
Wheaton Franciscan Healthcare - AllRacineWI4$500.00$265.00$163.27$163.27$440.50
Mercy Medical CenterOshkoshWI9$1,470.00$837.90$154.46$162.18$476.78
Ascension Ne Wisconsin-St. ElizabethAppletonWI9$1,470.00$837.90$154.46$162.18$476.78
Wfhc - Elmbrook MemorialBrookfieldWI4$156.01$156.01$440.50
Ascension Se Wisconsin Hospital IncMilwaukeeWI4$156.01$156.01$440.50
Wheaton Franciscan - FranklinFranklinWI4$156.01$156.01$440.50
MoshFranklinWI4$156.01$156.01$440.50
Ascension Wisconsin Emerus MenomoneeMenomonee FallsWI4$156.01$156.01$440.50
Holy Family Memorial IncManitowocWI10$152.81$152.81$165.04
Amery Regional Medical CenterAmeryWI7$482.00$251.31$18.20$144.63$433.80
Hudson HospitalHudsonWI8$386.00$174.12$74.06$132.17$386.00
Childrens WisconsinMilwaukeeWI29$138.75$76.31$97.13$117.38$131.81
Willow Creek Behavioral HealthGreen BayWI0$260.00
River Falls Area HospitalRiver FallsWI0$601.80$337.01
University Of Wi Hospitals & ClinicsMadisonWI0$409.00$245.40
Uw Health Rehabilitation HospitalMadisonWI0$409.00$245.40

Median is taken across all payer × plan combinations the hospital publishes. Cash and gross are the latest snapshot values. Range multiplier (max ÷ min) is a quick way to see which hospitals or payers vary the most.