CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Cleveland Clinic Martin North Hospital

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90791
Insurance Median: $161
Cash Discount Price: $899
vs. Medicare Baseline: 0.89x Medicare

The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Cleveland Clinic Martin North Hospital is $161. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $899. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 0.89x the Medicare baseline. Located in 200 Se Hospital Ave, Stuart, FL.

Cash / Self-Pay

$899

Average discount available for prompt cash payment at this facility.

Insurance Median

$161

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: $899 (496%)

Insurance Median: $161 (89%)

Cash: $899 (496% of Medicare)

Ins. Median: $161 (89% 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
Cigna	$128 - $164	71%
Freedom Health	$132 - $169	73%
Amerihealth	$136	75%
Miami Childrens Health Plan	$138 - $161	76%
Molina	$138	76%
Sunshine Health	$138	76%
Avmed	$145 - $621	80%
Blue Cross Blue Shield	$145 - $161	80%
United	$145 - $193	80%
Careplus	$153 - $169	84%
Independent Living Systems	$153 - $158	84%
Clear Spring Health	$157	87%
Aetna	$161 - $1,245	89%
Humana	$161	89%
Wellcare	$161	89%
Devoted Health	$177	98%
Multiplan	$218	120%
Clarity Health	$899	496%
The Legacy Companies	$899	496%
Consociate Health	$1,037	572%

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 $899.
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 Cleveland Clinic Martin North 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.