Psychiatric evaluation (first visit)
Facility: Kansas City Orthopaedic Institute
Billing Code: 90791 (CPT)
- CPT Billing Code: 90791
- Insurance Median: $368
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 2.03x 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 203% of the Medicare baseline (a markup of 103%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
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 |
|---|---|---|
| UnitedHealthcare | $142 | 78% |
| Aetna | $142 | 78% |
| Cigna | $151 | 83% |
| Blue Cross Blue Shield | $368 | 203% |
Consumer Guidance & Cost Commentary
For the psychiatric evaluation (first visit) at Kansas City Orthopaedic Institute in Leawood, KS, the facility's negotiated rates range from $142 to $368 depending on the insurance carrier, with UnitedHealthcare, Aetna, and Cigna all settling at $142 and Blue Cross Blue Shield at $368. These commercial rates are significantly higher than the Medicare benchmark of $181.34, reflecting the administrative costs and contract structures inherent in private insurance billing. While the facility is an Acute Care Hospital owned by physicians, patients should be aware that cash-pay options are not listed in this report; however, for those with high-deductible plans, paying out-of-pocket might be more cost-effective if the insurance negotiated rate exceeds the cash price, which is common when commercial rates are inflated by administrative overhead.
Consumers should verify their specific plan details before scheduling, as the $142 to $368 range represents the maximum allowed amounts under contract, not necessarily the lowest possible price. It is important to note that while the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, unexpected ancillary charges from out-of-network providers like emergency physicians or labs could still occur. To minimize costs, patients should explicitly request a "self-pay" or "prompt-pay" discount at registration, which can reduce the final bill by 20% to 50% by bypassing insurance claims processing. Additionally, if a detailed itemized bill is received, patients should request a line-by-line audit to identify any unbundled codes or services not rendered, ensuring the final charge aligns with the negotiated rate rather than a summary