CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: The Medical Center of Aurora & South Hospital

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90791
  • Insurance Median: $369
  • Cash Discount Price: $819
  • vs. Medicare Baseline: 2.03x Medicare
The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at The Medical Center of Aurora & South Hospital is $369. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $819. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 2.03x the Medicare baseline. Located in 1501 S Potomac St, Aurora, CO.
Cash / Self-Pay
$819

Average discount available for prompt cash payment at this facility.

Insurance Median
$369

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: $819 (452%)
Insurance Median: $369 (203%)
Cash: $819 (452% of Medicare)
Ins. Median: $369 (203% 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 203% of the Medicare baseline (a markup of 103%). 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
Vail Health $122 - $130 67%
Kaiser $160 - $304 88%
United $166 - $385 92%
Cigna $173 - $548 95%
Bright Health $240 - $257 132%
Pinnacol Workers Comp $245 135%
Multiplan $256 - $771 141%
Aetna $261 - $452 144%
Colorado Program For Children With Special Needs $336 - $360 185%
Western Plains Community Health $520 - $557 287%
Northcare $560 - $599 309%
Physician Health Partners $560 - $599 309%
Blue Cross Blue Shield $592 - $634 326%
Medical Development International $640 - $685 353%
Prime Health $720 - $771 397%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1501 S Potomac St, Aurora, CO 80012
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals