CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Children's Hospital Colorado

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90791
  • Insurance Median: $533
  • Cash Discount Price: $502
  • vs. Medicare Baseline: 2.94x Medicare
The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Children's Hospital Colorado is $533. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $502. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 2.94x the Medicare baseline. Located in 13123 E 16Th Ave, Aurora, CO.
Cash / Self-Pay
$502

Average discount available for prompt cash payment at this facility.

Insurance Median
$533

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: $502 (277%)
Insurance Median: $533 (294%)
Cash: $502 (277% of Medicare)
Ins. Median: $533 (294% 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 294% of the Medicare baseline (a markup of 194%). 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
Ccha Behavioral Health $36 - $67 20%
Integrated Health Plan $53 - $399 29%
Kaiser $121 - $1,943 67%
Rocky Mountain Health Plan Behavioral Health $142 - $1,064 78%
Valueoptions Colorado $150 83%
Carelon Behavioral Health $160 - $1,863 88%
Denver Health Medical Plan $160 - $1,996 88%
Presbyterian Health Plan $171 - $1,517 94%
Colorado Access $174 - $1,304 96%
Colorado Access Behavioral Health $174 - $1,304 96%
Molina Healthcare Of Nebraska $196 - $1,464 108%
Molina Healthcare Of New Mexico $196 - $1,464 108%
Peak Health Alliance/Ebms $196 - $1,597 108%
Rocky Mountain Health Plan $196 - $1,730 108%
Healthy Blue Of Nebraska $206 - $1,543 114%
Humana $217 - $1,863 120%
UnitedHealthcare $221 - $856 122%
Evernorth Behavioral Health $231 - $1,730 127%
Interlink National $231 - $1,996 127%
Centivo $246 - $1,836 136%
Select Health $249 - $1,863 137%
Uchealth Plan Administrators $249 - $1,863 137%
Blue Cross Blue Shield $253 - $1,996 140%
Cigna $257 - $922 142%
Aetna $260 - $1,943 143%
Department Of Corrections $278 - $2,076 153%
Comppsych Behavioral Health $303 - $2,262 167%
First Choice Health $303 - $2,262 167%
Midlands Choice $303 - $2,262 167%
National Preferred Provider Network $303 - $2,262 167%
Multiplan $306 - $2,288 169%
Cofinity $320 - $2,395 176%
First Choice Of The Midwest $320 - $2,395 176%
Usa Managed Care Organization $320 - $2,395 176%
First Health Network $328 - $2,448 181%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 13123 E 16Th Ave, Aurora, CO 80045
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens