CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Hca-Healthone DBA Swedish Medical Center

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90791
Insurance Median: $1,738
Cash Discount Price: $4,056
vs. Medicare Baseline: 9.58x Medicare

The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Hca-Healthone DBA Swedish Medical Center is $1,738. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,056. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 9.58x the Medicare baseline. Located in 501 E Hampden Ave, Englewood, CO.

Cash / Self-Pay

$4,056

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,738

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: $4,056 (2237%)

Insurance Median: $1,738 (958%)

Cash: $4,056 (2237% of Medicare)

Ins. Median: $1,738 (958% 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 958% of the Medicare baseline (a markup of 858%). 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 - $3,824	141%
Vail Health	$587 - $646	324%
Kaiser	$773 - $1,372	426%
United	$800 - $1,912	441%
Cigna	$915 - $2,719	505%
Bright Health	$1,159 - $1,275	639%
Aetna	$1,259 - $2,243	694%
Colorado Program For Children With Special Needs	$1,700 - $1,870	937%
Western Plains Community Health	$2,511 - $2,762	1385%
Northcare	$2,704 - $2,974	1491%
Physician Health Partners	$2,704 - $2,974	1491%
Blue Cross Blue Shield	$2,858 - $3,144	1576%
Medical Development International	$3,090 - $3,399	1704%
Prime Health	$3,477 - $3,824	1917%

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 $4,056.
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 DBA Swedish 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.