CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: HCA Healthone Mountain Ridge

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90791
Insurance Median: $626
Cash Discount Price: $1,478
vs. Medicare Baseline: 3.45x Medicare

The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at HCA Healthone Mountain Ridge is $626. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,478. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 3.45x the Medicare baseline. Located in 9191 Grant St, Thornton, CO.

Cash / Self-Pay

$1,478

Average discount available for prompt cash payment at this facility.

Insurance Median

$626

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: $1,478 (815%)

Insurance Median: $626 (345%)

Cash: $1,478 (815% of Medicare)

Ins. Median: $626 (345% 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 345% of the Medicare baseline (a markup of 245%). 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
Vail Health	$225	124%
Pinnacol Workers Comp	$245	135%
Multiplan	$256 - $1,330	141%
Kaiser	$279 - $525	154%
Cigna	$285 - $946	157%
United	$306 - $665	169%
Life Source Services	$350	193%
Bright Health	$443	244%
Aetna	$482 - $780	266%
Colorado Program For Children With Special Needs	$503	277%
Western Plains Community Health	$961	530%
Northcare	$1,035	571%
Physician Health Partners	$1,035	571%
Blue Cross Blue Shield	$1,094	603%
Medical Development International	$1,183	652%
Prime Health	$1,330	733%

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 $1,478.
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 Mountain Ridge 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.