Psychiatric evaluation (first visit)
Facility: Providence Medical Center
Billing Code: 90791 (CPT)
- CPT Billing Code: 90791
- Insurance Median: $221
- Cash Discount Price: $167
- vs. Medicare Baseline: 1.22x 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 |
|---|---|---|
| Cigna | $167 | 92% |
| UnitedHealthcare | $167 - $502 | 92% |
| Tricare | $167 | 92% |
| Midland Care Connection | $167 | 92% |
| Aetna | $167 | 92% |
| Medicare (plans) | $167 | 92% |
| Healthy Blue | $176 | 97% |
| Kansas Superior Select | $176 | 97% |
| Celtic | $176 - $268 | 97% |
| Comp Alliance - Fka Compresults Worker Compensation | $208 | 115% |
| Corizon | $217 | 120% |
| Oha Networks | $225 | 124% |
| Worker Compensation | $232 | 128% |
| Employer Direct Healthcare | $234 | 129% |
| Well Path Prison | $234 | 129% |
| Centurion | $251 | 138% |
| Naphcare | $259 | 143% |
| Blue Cross Blue Shield | $268 - $309 | 148% |
Consumer Guidance & Cost Commentary
For this psychiatric evaluation at Providence Medical Center in Kansas City, KS, the cash price is $167, which is significantly lower than the facility's gross charge of $505. While the facility's negotiated rates with insurance payers range from $167 to $309, these amounts are generally higher than the cash price due to administrative costs and contract structures. It is important to note that while the facility is a voluntary non-profit church-owned acute care hospital, patients with high-deductible plans may find the cash price more affordable if their insurance negotiated rate exceeds $167. Before scheduling, patients should explicitly request self-pay or prompt-pay discounts, as hospitals often offer fee reductions of 20% to 50% for upfront payments that bypass costly insurance billing cycles and claims processing.
The facility's pricing is benchmarked against federal standards, with a Medicare amount of $181.34. The cash price of $167 is lower than the Medicare rate, suggesting that paying out-of-pocket could result in immediate savings compared to standard commercial negotiations. However, patients must be aware that commercial negotiated rates can sometimes exceed the cash price, particularly for specific payer tiers where the high end of the range reaches $309. To ensure the lowest possible cost, consumers should verify their specific plan's allowed amount before treatment and avoid accepting summary bills, instead demanding a full itemized statement to identify any unbundled codes or services not rendered.