CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Grady Memorial Hospital

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90791
Insurance Median: $167
Cash Discount Price: $800
vs. Medicare Baseline: 0.92x Medicare

The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Grady Memorial Hospital is $167. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $800. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 0.92x the Medicare baseline. Located in 80 Jesse Hill, Jr Drive Se, Atlanta, GA.

Cash / Self-Pay

$800

Average discount available for prompt cash payment at this facility.

Insurance Median

$167

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: $800 (441%)

Insurance Median: $167 (92%)

Cash: $800 (441% of Medicare)

Ins. Median: $167 (92% 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
Peach State	$99 - $128	55%
Ambetter / Centene	$118 - $167	65%
Caresource	$119 - $268	66%
Amerigroup	$128 - $130	71%
Aetna	$143 - $356	79%
Blue Cross Blue Shield	$143 - $640	79%
Cigna	$143 - $473	79%
Humana	$143 - $167	79%
Kaiser	$143 - $607	79%
Medicare (plans)	$143 - $167	79%
UnitedHealthcare	$143 - $576	79%
Vaccn	$143 - $167	79%
Wellcare	$143 - $167	79%
Clear Spring Health	$151 - $176	83%
Clover	$151 - $176	83%
Usp Naphcare	$158 - $480	87%
Oscar Health	$204 - $520	112%
Multiplan	$616	340%

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 $800.
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 Grady Memorial 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.