CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: HCA Healthone Presbyterian St Luke's

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90791
Insurance Median: $1,642
Cash Discount Price: $3,649
vs. Medicare Baseline: 9.05x Medicare

The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at HCA Healthone Presbyterian St Luke's is $1,642. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,649. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 9.05x the Medicare baseline. Located in 1719 E 19Th Ave, Denver, CO.

Cash / Self-Pay

$3,649

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,642

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: $3,649 (2012%)

Insurance Median: $1,642 (905%)

Cash: $3,649 (2012% of Medicare)

Ins. Median: $1,642 (905% 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 905% of the Medicare baseline (a markup of 805%). 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
Pinnacol Workers Comp	$245	135%
Multiplan	$256 - $3,284	141%
Vail Health	$555	306%
Kaiser	$730 - $949	403%
United	$755 - $1,642	416%
Cigna	$927 - $2,335	511%
Aetna	$1,095 - $1,927	604%
Bright Health	$1,095	604%
Emerging Therapy Solutions	$1,751 - $2,335	966%
Kaiser National Transplant	$1,751	966%
Colorado Program For Children With Special Needs	$1,861	1026%
Western Plains Community Health	$2,372	1308%
Northcare	$2,554	1408%
Physician Health Partners	$2,554	1408%
Blue Cross Blue Shield	$2,700	1489%
Medical Development International	$2,919	1610%
Prime Health	$3,284	1811%

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 $3,649.
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 HCA Healthone Presbyterian St Luke's 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.