CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Gunnison Valley Hospital

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90791
Insurance Median: $90
Cash Discount Price: $98
vs. Medicare Baseline: 0.50x Medicare

The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Gunnison Valley Hospital is $90. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $98. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 0.50x the Medicare baseline. Located in 711 N Taylor St, Gunnison, CO.

Cash / Self-Pay

$98

Average discount available for prompt cash payment at this facility.

Insurance Median

$90

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: $98 (54%)

Insurance Median: $90 (50%)

Cash: $98 (54% of Medicare)

Ins. Median: $90 (50% 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.

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
Gunnison County Sheriff Op & Profee Only	$41 - $77	23%
Ebms Hdhp	$48 - $90	26%
Tetwp Op & Profee Only-All Plans	$48 - $90	26%
U Of Co Transplant-All Plans	$48 - $90	26%
Ebms Ppo Plan-All Other Plans	$56 - $105	31%
Gunnison County Employees-All Other Plans	$64 - $120	35%
Scottish Rites-All Plans	$64 - $120	35%
Elap Employers-All Plans	$68 - $128	37%
Blue Cross Blue Shield	$70 - $131	39%
Multiplan-All Plans	$72 - $135	40%
Rocky Mountain Health-All Plans	$76 - $142	42%
UnitedHealthcare	$76 - $142	42%
Cofinity-All Plans	$77 - $144	42%
Medicare (plans)	$144	79%
Medicaid / KanCare	$160	88%
Aetna	$209	115%
Apostrophe-All Plans	$238	131%
Cigna	$238	131%

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 $98.
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 Gunnison Valley Hospital 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.