CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Grossmont Hospital

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90791
  • Insurance Median: $634
  • Cash Discount Price: $750
  • vs. Medicare Baseline: 3.50x Medicare
The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Grossmont Hospital is $634. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $750. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 3.50x the Medicare baseline. Located in 5555 Grossmont Center Drive Box 58, La Mesa, CA.
Cash / Self-Pay
$750

Average discount available for prompt cash payment at this facility.

Insurance Median
$634

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: $750 (414%)
Insurance Median: $634 (350%)
Cash: $750 (414% of Medicare)
Ins. Median: $634 (350% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 350% of the Medicare baseline (a markup of 250%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Allianz Global Assistance $52 - $297 29%
Aetna $297 - $750 164%
Community Health Group $297 164%
Medi-Cal $297 - $479 164%
Health Net $300 - $900 165%
Blue Cross Blue Shield $340 - $700 187%
Humana $340 187%
Epic Americas $393 - $395 217%
Multiplan $393 217%
California Health And Wellness $420 232%
Blue Shield $500 - $900 276%
Indian Health Council $557 - $656 307%
County Medical Services $638 352%
Molina $638 - $750 352%
Cigna $700 386%
Kaiser $700 386%
San Diego Pace $700 - $750 386%
UnitedHealthcare $750 - $900 414%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 5555 Grossmont Center Drive Box 58, La Mesa, CA 91942
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals