CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Adventist Health Sonora

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90791
  • Insurance Median: $255
  • Cash Discount Price: $66
  • vs. Medicare Baseline: 1.41x Medicare
The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Adventist Health Sonora is $255. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $66. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.41x the Medicare baseline. Located in 1000 Greenley Road, Sonora, CA.
Cash / Self-Pay
$66

Average discount available for prompt cash payment at this facility.

Insurance Median
$255

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: $66 (36%)
Insurance Median: $255 (141%)
Cash: $66 (36% of Medicare)
Ins. Median: $255 (141% 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.

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
Bc Mcal $128 71%
Celtic Ca Hlth Well Mcal - All Plans $128 - $253 71%
Central Ca Alliance Mcal $128 - $208 71%
Healthnet Mcal $128 - $274 71%
Medi-Cal $128 - $184 71%
Blue Shield Mcare $140 - $244 77%
Central Ca Alliance Mcr Adv Profee Only $140 77%
Healthnet Mcr Adv $140 - $244 77%
Tricare $140 - $244 77%
UnitedHealthcare $140 - $368 77%
Ah Employee Health Plan - All Plans $154 - $440 85%
Cigna $172 - $370 95%
Greatwest Oa/Pos/Hmo $182 - $332 100%
Greatwest Ppo - All Other Plans $182 - $351 100%
Central Ca Alliance Ccs Mcal $192 - $208 106%
Central Ca Alliance Comm Profee Only-All Other Pla $192 106%
Kaiser - All Plans $195 108%
Western Growers/Pinnacle - All Plans $195 - $281 108%
Healthnet - All Other Plans $204 - $342 112%
Central Ca Alliance Chdp Mcal $208 - $256 115%
Bc Exchange $234 129%
Blue Shield Epn $243 - $296 134%
Aetna $244 - $271 135%
Phs Prime Health Srvcs-All Plans $244 135%
Blue Shield - All Other Plans $257 - $296 142%
Bc Mcs $260 - $329 143%
Bc Non-Mcs - All Other Plans $260 - $329 143%
Trpn - Three Rivers Ppo - All Plans $312 - $384 172%
Beech Street- All Plans $326 - $384 180%
Affordable Health - All Plans $351 194%
Interplan - All Plans $351 194%
Multiplan - All Plans $351 194%
Phcs Ppo - All Plans $351 194%
Stanilaus Foundation - All Plans $370 204%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1000 Greenley Road, Sonora, CA 95370
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals