CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Kirby Medical Center

Billing Code: 90791 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$133

about 0.7× the $181 Medicare rate · typically $117–$167

modeled estimate · not a bill or quote

What this hospital charges insurers

$137

About the fair price

about $4 over the fair price · 0.8× Medicare

Medicare pays $181 Fair price $133 This hospital $137 Cash price $384 Hospital's list price $640

How we calculate the fair BaseRate →

How this hospital compares to other IL hospitals

One of the lower prices — 6 of 8 other IL hospitals charge more for the same procedure.

Cheapest $119 Priciest $167

Black dot = this hospital, among the 9 IL hospitals with a price for this procedure. Full list below.

A fair price for a Psychiatric evaluation (first visit) is about $133 (about 0.7× the $181 Medicare rate). Kirby Medical Center charges insurers about $137, or about $384 in cash — about the fair price. Located in Monticello, IL.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$112 - $441	62%
Blue Cross Blue Shieldmajor	$110 - $627	61%
Aetnamajor	$119 - $448	66%
Cignamajor	$512	282%
Humanamajor	$198 - $480	109%
HealthLink	$576	318%
Meridian	$119 - $198	66%
Molina	$125 - $204	69%
WellCare	$137 - $198	76%
+ 1 smaller / regional plan	$185 - $544

Excludes 2 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 384), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 90791.

Insurance Before you use insurance

Call your insurance company to confirm Kirby Medical Center is in-network.
Ask your insurer whether prior approval is required for CPT code 90791.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Kirby Medical Center

Compare: Psychiatric evaluation (first visit) at other IL hospitals

Insurance negotiated median for the same procedure, sorted lowest first.