CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: University of Miami Hospital and Clinics

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90791
Insurance Median: $379
Cash Discount Price: $198
vs. Medicare Baseline: 2.09x Medicare

The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at University of Miami Hospital and Clinics is $379. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $198. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 2.09x the Medicare baseline. Located in 1475 Nw 12Th Ave Suite 2175, Miami, FL.

Cash / Self-Pay

$198

Average discount available for prompt cash payment at this facility.

Insurance Median

$379

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: $198 (109%)

Insurance Median: $379 (209%)

Cash: $198 (109% of Medicare)

Ins. Median: $379 (209% 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 209% of the Medicare baseline (a markup of 109%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
UnitedHealthcare	$181 - $379	100%
Careplus	$184	101%
Sunshine Health	$184	101%
Aetna	$196 - $404	108%
Molina Healthcare Of Fl	$198	109%
Solis Health	$199	110%
Amerihealth Caritas Fl	$206	114%
Humana	$206	114%
Oscar Health Of Fl	$206	114%
Blue Cross Blue Shield	$220 - $316	121%
Cigna	$265 - $320	146%
Curative	$390	215%
Avmed	$419 - $478	231%
Employers Health Network	$441	243%
Simply Healthcare	$441	243%
First Health	$478	264%
Health First New York Health Insurance	$478	264%
Broward Health	$514	283%
Beech Street	$588	324%
Dimension Health	$588	324%
Multiplan	$588	324%

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 $198.
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 University of Miami Hospital and Clinics 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.