CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Presence Mercy Medical Center

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90791
  • Insurance Median: $197
  • Cash Discount Price: $189
  • vs. Medicare Baseline: 1.09x Medicare
The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Presence Mercy Medical Center is $197. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $189. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.09x the Medicare baseline. Located in 1325 N Highland Avenue, Aurora, IL.
Cash / Self-Pay
$189

Average discount available for prompt cash payment at this facility.

Insurance Median
$197

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: $189 (104%)
Insurance Median: $197 (109%)
Cash: $189 (104% of Medicare)
Ins. Median: $197 (109% 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
Ravenswood Physicians Associates Ipa $139 - $189 77%
Resurrection Physicians Provider Group Ipa $139 - $189 77%
Blue Cross Blue Shield $180 - $312 99%
Advocate Helath Partners $189 - $208 104%
Aetna $189 - $312 104%
Celtic (Wellcare) $189 104%
Cigna $189 104%
Clear Spring Health Of Illinois $189 104%
Devoted Health $189 104%
Essential Health Partners $189 - $218 104%
Health Alliance Medical Plan $189 104%
Humana $189 - $312 104%
Longevity Health Plan Of Illinois $189 104%
Medicare (plans) $189 104%
Self-Pay $189 104%
Tricare $189 104%
United Behavioral Health $189 104%
UnitedHealthcare $189 - $418 104%
Molina $195 - $327 108%
Zing Health Provider Network $195 108%
Meridian $199 - $327 110%
Provider Partners Health Plan (Pphp) $199 110%
Harmony Health Plan $201 - $327 111%
Access Community Health Network $227 125%
Clifton Health Systems $293 162%
Ambetter / Centene $307 169%
Medicaid / KanCare $312 - $327 172%
Standard Eapg Logic - Contracts $312 172%
Evernorth Behavioral Health $799 441%
Healthlink, Inc. $900 496%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1325 N Highland Avenue, Aurora, IL 60506
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals