Psychiatric evaluation (first visit)
Facility: University Of Kansas Health System - St Francis Campus
Billing Code: 90791 (CPT)
- CPT Billing Code: 90791
- Insurance Median: $298
- Cash Discount Price: $155
- vs. Medicare Baseline: 1.64x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Lucent Health [6000] | $212 | 117% |
| Aetna | $212 | 117% |
| Oncology Patient Assistance Programs [2295] | $212 | 117% |
| Blue Cross Blue Shield | $212 | 117% |
| Black Lung [6055] | $212 | 117% |
| Hooray Health [8000] | $212 | 117% |
| Web Tpa [2115] | $212 | 117% |
| Healthcare Highways [2210] | $212 | 117% |
| Department Of Corrections [1340] | $258 | 142% |
| Healthpartners [1500] | $298 | 164% |
| Cigna | $298 | 164% |
| American Postal Workers Union [1070] | $298 | 164% |
| National Association Of Letter Carriers [1695] | $298 | 164% |
| Humana | $304 | 168% |
| Geha [1415] | $341 | 188% |
| UnitedHealthcare | $341 | 188% |
| Healthscope Benefits [2290] | $341 | 188% |
| 1199 Seiu Benefit Fund [3505] | $347 | 191% |
| Worker'S Comp [2125] | $361 | 199% |
| Enablecomp [1350] | $361 | 199% |
| Administrative Concepts [1005] | $401 | 221% |
| First Health [1375] | $401 | 221% |
| American Healthcare [1055] | $401 | 221% |
| Multiplan [1680] | $401 | 221% |
| Coventry Healthcare [1320] | $423 | 233% |
Consumer Guidance & Cost Commentary
For this psychiatric evaluation at the University of Kansas Health System - St Francis Campus in Topeka, the cash payment rate of $155.00 is significantly lower than the facility's negotiated rate of $298.00 and the gross charge of $516.00. While the facility's negotiated rate of $298.00 is higher than the cash price, it remains below the gross charge, reflecting standard insurance contract dynamics. Patients with high-deductible plans may find the cash rate of $155.00 more cost-effective than the negotiated rate of $298.00, as paying out-of-pocket avoids the administrative overhead and markup associated with insurance billing cycles. It is advisable to contact the hospital directly to confirm if "self-pay" or "prompt-pay" discounts are available before scheduling, as these upfront payment incentives can further reduce the final amount owed.
The facility's pricing is benchmarked against the Medicare rate of $181.34, which serves as a scientifically validated baseline for healthcare costs. The cash rate of $155.00 is approximately 85% of the Medicare amount, while the negotiated rate of $298.00 represents roughly 164% of the Medicare rate. This comparison highlights that commercial negotiated rates often exceed the Medicare benchmark due to administrative structures and contract dynamics, whereas the cash rate aligns closely with the true cost of service delivery. For transparency, the facility is a voluntary non-profit church-owned hospital located in Topeka, Kansas, and patients should review their specific plan details to understand how these rates apply to their coverage.