CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Sharp Coronado Hospital and Hlthcr Ctr

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90791
Insurance Median: $565
Cash Discount Price: $750
vs. Medicare Baseline: 3.12x Medicare

The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Sharp Coronado Hospital and Hlthcr Ctr is $565. 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 3.12x the Medicare baseline. Located in 250 Prospect Place, Coronado, CA.

Cash / Self-Pay

$750

Average discount available for prompt cash payment at this facility.

Insurance Median

$565

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: $565 (312%)

Cash: $750 (414% of Medicare)

Ins. Median: $565 (312% 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 312% of the Medicare baseline (a markup of 212%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Health Net	$64 - $750	35%
Molina	$64	35%
Aetna	$280 - $750	154%
Blue Cross Blue Shield	$297 - $800	164%
Blue Shield	$420 - $750	232%
California Health And Wellness	$557 - $600	307%
Cigna	$557 - $675	307%
Humana	$557	307%
Allianz Global Assistance	$638	352%
UnitedHealthcare	$655 - $670	361%
Interplan	$663	366%
Managed Health Network	$750	414%
Medicare (plans)	$750	414%

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 $750.
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 Sharp Coronado Hospital and Hlthcr Ctr 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.