CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Banner Payson Medical Center

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90791
Insurance Median: $143
Cash Discount Price: $179
vs. Medicare Baseline: 0.79x Medicare

The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Banner Payson Medical Center is $143. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $179. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 0.79x the Medicare baseline. Located in 807 South Ponderosa Drive, Payson, AZ.

Cash / Self-Pay

$179

Average discount available for prompt cash payment at this facility.

Insurance Median

$143

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: $179 (99%)

Insurance Median: $143 (79%)

Cash: $179 (99% of Medicare)

Ins. Median: $143 (79% 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
Arizona Physicians Ipa	$97 - $130	53%
Banner University Health Plan	$97 - $130	53%
Health Choice Arizona, Inc.	$97 - $185	53%
Health Net	$97 - $192	53%
Mercy Care	$97 - $130	53%
Aetna	$129 - $210	71%
Banner Health	$130	72%
Blue Cross Blue Shield	$130 - $918	72%
Care 1St	$130	72%
Cigna	$130 - $252	72%
Gila River Health Care Corporation	$130	72%
Kaiser Foundation Health Plan	$130	72%
Triwest Healthcare Alliance Corp - Va Ccn	$130	72%
UnitedHealthcare	$130 - $212	72%
Upmc Health Plan	$130	72%
Wellpoint	$130	72%
Carelon	$136	75%
Humana	$138	76%
Arizona Priority Care	$143	79%
Devoted Health Services	$143	79%
Gold Kidney Health Plan	$143	79%
National Healthcare Solutions Inc (Nhsi) And Vip Universal Medical Insurance Group (Vumi)	$143	79%
Plotkin Health	$143	79%
Oscar Health Plan	$214	118%
Quiktrip Corporation	$222	122%
Arizona Medical Network	$285	157%
Provider Network Of America	$285	157%

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 $179.
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 Banner Payson 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.