Psychiatric evaluation (first visit)
Facility: St. Catherine Hospital - Garden City
Billing Code: 90791 (CPT)
- CPT Billing Code: 90791
- Insurance Median: $141
- Cash Discount Price: $191
- vs. Medicare Baseline: 0.78x 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 |
|---|---|---|
| Denver Health | $60 - $165 | 33% |
| Direct To Employer | $69 - $280 | 38% |
| Kaiser | $70 - $193 | 39% |
| Centura Employee Plan | $94 - $350 | 52% |
| United Colorado Doctor'S Plan | $96 - $263 | 53% |
| Peak Health | $100 - $329 | 55% |
| Aetna | $102 - $385 | 56% |
| UnitedHealthcare | $115 - $406 | 63% |
| Cigna | $120 - $420 | 66% |
| Humana | $137 - $141 | 76% |
| Blue Cross Blue Shield | $137 - $343 | 76% |
| Medicare (plans) | $137 - $141 | 76% |
| Kansas Health | $137 | 76% |
| Devoted Health | $141 | 78% |
| Innovage | $141 | 78% |
| Multiplan | $179 - $595 | 99% |
Consumer Guidance & Cost Commentary
For the psychiatric evaluation (first visit) at St. Catherine Hospital in Garden City, KS, the cash price is $191.00, which is significantly lower than the facility's gross charge of $478.00. While the hospital's negotiated rates with major payers like Aetna and UnitedHealthcare range from $102 to $406, the cash price of $191.00 may be the most cost-effective option for patients with high-deductible plans or those without insurance, as it avoids the administrative markup often found in commercial contracts. It is important to note that Medicare allows a payment of $181.34 for this service, and the facility's negotiated average is $141.00; however, patients should verify their specific plan's allowed amount before scheduling, as some commercial rates exceed the cash price.
Patients should be aware that while the No Surprises Act protects against balance billing for emergency care and non-emergency services from out-of-network providers at in-network facilities, unexpected charges can still occur if ancillary services like labs or emergency physicians are out-of-network. To minimize costs, consumers should request a full itemized bill before paying, as summary invoices often hide unbundled codes or services not rendered. Additionally, asking the hospital about "self-pay" or "prompt-pay" discounts prior to check-in can result in immediate fee reductions, and disputing any balance bills in writing ensures that patients are not forced to pay the difference between the chargemaster and their insurance allowed amount.