CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Griffin Hospital

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90791
Insurance Median: $331
Cash Discount Price: $192
vs. Medicare Baseline: 1.83x Medicare

The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Griffin Hospital is $331. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $192. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.83x the Medicare baseline. Located in 130 Division St, Derby, CT.

Cash / Self-Pay

$192

Average discount available for prompt cash payment at this facility.

Insurance Median

$331

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: $192 (106%)

Insurance Median: $331 (183%)

Cash: $192 (106% of Medicare)

Ins. Median: $331 (183% 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
Magellan	$104 - $160	57%
Cigna	$108 - $490	60%
United Behavioral Health	$157 - $209	87%
Aetna	$192 - $340	106%
Blue Cross Blue Shield	$192 - $646	106%
Carepartners of Connecticut	$192	106%
Connecticare	$192	106%
UnitedHealthcare	$192 - $424	106%
Connecticare (Cbi)	$326 - $356	180%
Connecticare (Cci)	$390 - $425	215%
Oxford	$421 - $459	232%
Centivo	$522 - $569	288%

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 $192.
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 Griffin 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.