CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: John Muir Behavioral Health Center

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90791
  • Insurance Median: $929
  • Cash Discount Price: $760
  • vs. Medicare Baseline: 5.12x Medicare
The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at John Muir Behavioral Health Center is $929. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $760. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 5.12x the Medicare baseline. Located in 2740 Grant Street, Concord, CA.
Cash / Self-Pay
$760

Average discount available for prompt cash payment at this facility.

Insurance Median
$929

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: $760 (419%)
Insurance Median: $929 (512%)
Cash: $760 (419% of Medicare)
Ins. Median: $929 (512% 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 512% of the Medicare baseline (a markup of 412%). 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
Contra Costa County Jail [1012104] $743 410%
Federal Correction Institute [1062104] $743 410%
Fortified Provider Network [1063104] $743 410%
Galaxy Health Network [1064104] $743 410%
Health Management Network [1066104] $743 410%
Healthsmart - Pka Interplan [1031104] $743 410%
Hospice Of East Bay [1085104] $743 410%
Humana $743 410%
Integrated Health Plan [1075104] $743 410%
Medigap [1036001] $743 410%
National Provider Network/Plancare America [1069104] $743 410%
Networks By Design [1084104] $743 410%
Pponext [1072104] $743 410%
Sutter Preferred Health Plan [1044104] $743 410%
Three Rivers Provider Network [1073104] $743 410%
Blue Shield Hmo [1006103] $813 448%
Blue Shield Ppo [1006104] $813 448%
Blue Shield-Network [1006026] $813 448%
Carelon Behavioral Health [1050104] $929 512%
Health Net Hmo [1028103] $929 512%
Health Net Ppo [1028104] $929 512%
Health Net-Network [1028026] $929 512%
Aetna $1,014 559%
Aps Healthcare [1003103] $1,014 559%
Blue Cross Blue Shield $1,014 - $1,165 559%
Brms [1091104] $1,014 559%
Delta Health Systems [1032104] $1,014 559%
Empire Plan [1092104] $1,014 559%
Healthcomp [1089104] $1,014 559%
Kaiser Hmo [1033103] $1,014 559%
Carecentrix [1011001] $1,250 689%
Donor Network West [1008103] $1,250 689%
Generic Commercial/Indemnity [1017001] $1,250 689%
Western Health Advantage Hmo [1053103] $1,250 689%
Cigna $1,267 699%
Beacon Health Strategies [1005103] $1,352 746%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2740 Grant Street, Concord, CA 94520
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Psychiatric