CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Highland Hospital

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90791
Insurance Median: $230
Cash Discount Price: $185
vs. Medicare Baseline: 1.27x Medicare

The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Highland Hospital is $230. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $185. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.27x the Medicare baseline. Located in 1411 East 31St Street, Oakland, CA.

Cash / Self-Pay

$185

Average discount available for prompt cash payment at this facility.

Insurance Median

$230

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: $185 (102%)

Insurance Median: $230 (127%)

Cash: $185 (102% of Medicare)

Ins. Median: $230 (127% 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
UnitedHealthcare	$133 - $177	73%
Kaiser Medi-Cal Managed Care [1026106]	$163	90%
Aetna	$181 - $226	100%
Blue Shield [1006001]	$195 - $230	108%
Blue Cross Blue Shield	$220 - $230	121%
Kaiser Commercial [1026001]	$240	132%
Cigna	$277	153%
Alameda Alliance Commercial Alternate [4801]	$315	174%
Alameda Alliance Mgd Mcal Alternate [2801]	$315	174%
Alameda Alliance Non-Verified [1002303]	$315	174%
Alameda Alliance [1002106]	$315	174%
Alameda Alliance [1002206]	$315	174%
Mc Alameda Alliance Capitation [1002103]	$315	174%

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 $185.
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 Highland Hospital 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.