CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: University Of Kansas Hospital

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90791
  • Insurance Median: $276
  • Cash Discount Price: $86
  • vs. Medicare Baseline: 1.52x Medicare
The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at University Of Kansas Hospital is $276. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $86. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.52x the Medicare baseline. Located in 4000 Cambridge Street, Kansas City, KS.
Cash / Self-Pay
$86

Average discount available for prompt cash payment at this facility.

Insurance Median
$276

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: $86 (47%)
Insurance Median: $276 (152%)
Cash: $86 (47% of Medicare)
Ins. Median: $276 (152% 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
Larned State Hospital [503200090] $115 - $137 63%
Hchsync Centrus Health Direct [503999916] $117 - $163 65%
National Assn Letter Carriers [503200019] $125 69%
Cigna $125 - $295 69%
Blue Cross Blue Shield $150 - $357 83%
Alt Theramatrix [5032000967] $161 - $192 89%
Health Plan Inc [503999941] $183 - $219 101%
Tricare $195 - $232 108%
Accarent Health [503999034] $195 - $232 108%
Humana $195 - $232 108%
Alt Carelon Behavioral Health [503200905] $195 - $232 108%
Meritain Health [503200039] $201 - $391 111%
Coventry [503200022] $201 - $315 111%
Aetna $201 - $315 111%
Coresource [503200089] $201 - $240 111%
Workers Comp [503999901] $203 - $442 112%
Php [503200005] $234 - $344 129%
Allied National [503999937] $234 - $279 129%
Healthlink [503200007] $236 - $344 130%
Inter-Americas Insurance [503999032] $236 - $282 130%
Med-Pay [503200040] $236 - $282 130%
Alt Wppa [5032000964] $236 - $282 130%
Geha [503200036] $236 - $282 130%
Cerner [503200038] $236 - $282 130%
Mh Net [503999024] $238 - $284 131%
Alt Coventry Advantra Mhnet [50311260] $238 - $284 131%
Alt Coventry Mhnet [503200030] $238 - $284 131%
Aha-Healthcare Preferred [503200050] $257 - $306 142%
First Health [5032000110] $257 - $306 142%
Alt Meritain Health [503999911] $264 - $315 146%
Ascension Living Hope [503201517] $273 - $326 151%
Coeur Plan Services [503301517] $273 - $326 151%
Consolidated Billing [50311256] $273 - $326 151%
Correct Care Solutions [50311253] $273 - $326 151%
Orscheln Industries [503201608] $292 - $349 161%
Alt Lineco [5032000976] $299 - $357 165%
Empire Plan/Nyship [503200705] $299 - $357 165%
Alt Lucent Health Solutions [503202603] $299 - $357 165%
Point Comfort Underwriters [503200018] $312 - $372 172%
Triwest [503201703] $312 - $372 172%
Quiktrip [5032000412] $312 - $372 172%
Century Health Solutions [503200054] $312 - $372 172%
Wppa [503200056] $328 - $391 181%
Employers Health Network [503999025] $351 - $418 194%
Plan Care America [503999026] $351 - $418 194%
Usa Managed Care [503999030] $351 - $418 194%
Sanford Health Plan [503999027] $351 - $418 194%
Three Rivers Provider Network [503999029] $351 - $418 194%

Consumer Guidance & Cost Commentary

For the psychiatric evaluation (first visit) at University Of Kansas Hospital, the facility's cash price of $86.00 is significantly lower than the median negotiated rate of $247.00 paid by insurance payers. While the hospital is a government-owned acute care facility in Kansas City, KS, patients with high-deductible plans may find the cash price more advantageous if their insurance negotiated rates exceed this amount. It is important to note that commercial rates often include administrative overhead and contract markups that can inflate the baseline price by 20% to 40%, making the direct cash price a strong benchmark for self-pay patients.

Patients should verify their specific plan details before scheduling, as insurance companies negotiate different rates that can vary widely across the 48 payers listed for this service. Although the No Surprises Act protects patients from balance billing for out-of-network providers at in-network facilities, it is crucial to confirm that all ancillary services, such as laboratory tests or emergency physician visits, are also covered under the plan. To minimize costs, individuals should contact the hospital directly to inquire about "self-pay" or "prompt-pay" discounts, which can offer a fee reduction of 20% to 50% for upfront payment, effectively bypassing the costly claims processing cycle associated with insurance billing.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 4000 Cambridge Street, Kansas City, KS 66160
  • CMS Rating: ★★★★★
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals