CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Larkin Community Hospital

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90791
  • Insurance Median: $275
  • Cash Discount Price: $294
  • vs. Medicare Baseline: 1.52x Medicare
The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Larkin Community Hospital is $275. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $294. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.52x the Medicare baseline. Located in 7031 Sw 62Nd Ave, South Miami, FL.
Cash / Self-Pay
$294

Average discount available for prompt cash payment at this facility.

Insurance Median
$275

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: $294 (162%)
Insurance Median: $275 (152%)
Cash: $294 (162% of Medicare)
Ins. Median: $275 (152% 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.

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
Humana $50 - $597 28%
Cigna $69 - $149 38%
Carisk Concordia Behavioral-All Plans $70 39%
Healthsun-All Plans $82 - $179 45%
Medicare (plans) $104 - $627 57%
Jipa Network-All Plans $105 - $179 58%
Medicaid / KanCare $110 - $275 61%
Star Network-All Plans $110 - $239 61%
Corvel Mcaid Workers Comp $142 78%
Sunshine Behavioral $142 78%
Aetna $148 - $597 82%
Fci-All Plans $148 - $185 82%
Global Excel-All Plans $148 - $358 82%
Jmh Health Plan Hmo/Ppo-All Other Plans $151 - $328 83%
Blue Cross Blue Shield $153 84%
Clear Springs Hlth-All Plans $156 - $169 86%
Ambetter / Centene $157 87%
Community Care Phks Mcaid-All Other Plans $157 87%
Florida Comm Care Mcaid $157 87%
Magellan Complete Care $157 87%
Molina Exch Marketplace-All Other Plans $157 87%
UnitedHealthcare $157 - $711 87%
Florida Comm Care Mcare-All Other Plans $161 89%
Ops Maritime-All Plans $161 89%
Opus Hospice Ip Only-All Plans $161 89%
Preferred Care Partners Mcare-All Plans $161 89%
Avmed-All Plans $162 - $597 89%
Bright Health-All Other Plans $162 - $716 89%
Coventry Comml-All Plans $162 - $597 89%
Haa Preferred Partners-All Plans $165 - $358 91%
Unicare Simply Mcare Ppo-All Plans $169 93%
Fdc-All Plans $170 94%
Wellpath-All Plans $177 98%
Allianz (Azga)-All Plans $210 116%
Corvel Mcare Workers Comp-All Plans $248 - $537 137%
Careplus Health-All Other Plans $275 - $597 152%
Centurion-All Plans $275 - $597 152%
Doctors Healthcare-All Plans $275 - $597 152%
First Med Hp Of Fl-All Plans $275 - $597 152%
Florida Health Solution/Hmo-All Plans $275 - $597 152%
United Prop Casualty-All Plans $462 255%
Oscar Health-All Plans $550 - $1,194 303%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 7031 Sw 62Nd Ave, South Miami, FL 33143
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals