CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: HCA Florida Sarasota Doctors Hospital

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90791
Insurance Median: $139
Cash Discount Price: $700
vs. Medicare Baseline: 0.77x Medicare

The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at HCA Florida Sarasota Doctors Hospital is $139. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $700. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 0.77x the Medicare baseline. Located in 5731 Bee Ridge Rd, Sarasota, FL.

Cash / Self-Pay

$700

Average discount available for prompt cash payment at this facility.

Insurance Median

$139

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: $700 (386%)

Insurance Median: $139 (77%)

Cash: $700 (386% of Medicare)

Ins. Median: $139 (77% 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
Access 2 Healthcare Physicians Freedom Optimum Group Members	$33	18%
Access 2 Healthcare Physicians Freedom Health	$50	28%
Access 2 Healthcare Physicians Optimum	$50	28%
Freedom Health Care	$55	30%
Optimum Healthcare	$55	30%
Avmed	$56 - $175	31%
Truli	$60 - $85	33%
Blue Cross Blue Shield	$62 - $142	34%
Simply Healthcare	$103 - $108	57%
Aetna	$104 - $210	57%
Oscar	$105	58%
United	$115 - $315	63%
Cigna	$122	67%
Molina	$133 - $189	73%
Corvel Corporation	$134 - $248	74%
Rockport Healthcare Group	$134 - $248	74%
Prime Health	$137 - $253	76%
Evolutions Healthcare Systems	$161 - $644	89%
Sunshine State Health Plan	$178	98%
Humana	$196	108%
Behealthy America	$273	151%
Beacon Health Options	$350	193%
Healthcare Sarasota	$350	193%
Plotkin Health	$350	193%
Prime Health Sheriff	$350	193%
Multiplan	$525 - $595	290%
Evernorth	$560	309%

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 $700.
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 HCA Florida Sarasota Doctors 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.