CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Loma Linda University Medical Center

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90791
Insurance Median: $225
Cash Discount Price: $169
vs. Medicare Baseline: 1.24x Medicare

The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Loma Linda University Medical Center is $225. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $169. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.24x the Medicare baseline. Located in 11234 Anderson St, Loma Linda, CA.

Cash / Self-Pay

$169

Average discount available for prompt cash payment at this facility.

Insurance Median

$225

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: $169 (93%)

Insurance Median: $225 (124%)

Cash: $169 (93% of Medicare)

Ins. Median: $225 (124% 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
Adventist Health	$30 - $204	17%
Lluh Dept Of Risk Management	$30 - $121	17%
Kaiser Foundation Hospitals	$57 - $402	31%
Blue Shield Of California	$60 - $368	33%
Epic Health Plan	$60 - $276	33%
Blue Cross Blue Shield	$73 - $354	40%
Global Benefits Group	$90 - $362	50%
Temecula Valley Physicians Medical Group	$90 - $362	50%
Trivalley Medical Group	$90 - $362	50%
Aetna	$91 - $366	50%
Cigna	$96 - $446	53%
Networks By Design	$98 - $392	54%
Multiplan	$112 - $452	62%
Central Health Plan	$120 - $482	66%
Galaxy Health	$128 - $513	71%
Prime Health Services	$128 - $513	71%
Health Management Network	$135 - $543	74%
Alpha Care Medical Group	$204 - $306	112%
Dignity Health	$204 - $306	112%
Inland Empire Health Plan (Iehp)	$204 - $220	112%
UnitedHealthcare	$204 - $1,570	112%
Upland Medical Group	$204	112%
Vantage Medical Group	$204 - $306	112%
Riverside University Health System	$225	124%
Molina Healthcare Of Ca	$274	151%
Heritage Provider Network	$335	185%

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 $169.
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 Loma Linda University 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.