CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Mt Sinai Hospital Medical Center

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90791
  • Insurance Median: $214
  • Cash Discount Price: $279
  • vs. Medicare Baseline: 1.18x Medicare
The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Mt Sinai Hospital Medical Center is $214. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $279. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.18x the Medicare baseline. Located in 15Th Street at California, Chicago, IL.
Cash / Self-Pay
$279

Average discount available for prompt cash payment at this facility.

Insurance Median
$214

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: $279 (154%)
Insurance Median: $214 (118%)
Cash: $279 (154% of Medicare)
Ins. Median: $214 (118% 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
Partners In Hlth - All Plans $122 - $196 67%
Blue Cross Blue Shield $136 - $423 75%
Cigna $172 - $607 95%
Compsych Ip/Op Only - All Plans $183 - $294 101%
Tricare $184 101%
Va Healthnet - All Plans $184 101%
Advocate Physician Prtnrs Mcr $190 105%
Cenpatico Illinicare Dual $190 105%
Cenpatico Illinicare Mcr - All Other Plans $190 105%
Evernorth Behav Hlth Mcr Adv $190 105%
Humana $190 - $1,541 105%
Lawndale Christian - All Plans $190 105%
Meridian/Harmony D-Snp - All Plans $190 105%
Nextlevel Hlth Icp Fhp Aca - All Plans $190 105%
UnitedHealthcare $190 - $196 105%
Harmony Behavioral Htlh - All Plans $196 108%
Healthlink Hmo $198 - $319 109%
Hfn Platinum $198 - $319 109%
Zing Mcr Adv - All Plans $198 109%
Molina Mcr - All Other Plans $200 110%
Advocate Physician Prtnrs - All Other Plans $209 115%
Ambetter / Centene $209 - $515 115%
Healthlink Ppo - All Other Plans $214 - $344 118%
Multiplan Primary Ntwrk/Phcs - All Other Plans $214 - $344 118%
Hfn Epo $244 - $393 135%
Multiplan Complementary Ntwrk $244 - $393 135%
Hfn Ppo - All Other Plans $268 - $432 148%
Oscar - All Plans $336 - $540 185%
Aetna $423 - $1,109 233%
Cenpatico Illinicare Bh Mcaid $423 233%
Family Health Network Mcaid - All Plans $423 233%
Molina Mcaid $444 245%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 15Th Street at California, Chicago, IL 60608
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals