Psychiatric evaluation (first visit)
Facility: Grisell Memorial Hospital
Billing Code: 90791 (CPT)
- CPT Billing Code: 90791
- Insurance Median: $297
- Cash Discount Price: $324
- 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 |
|---|---|---|
| Blue Cross Blue Shield | $159 | 88% |
| UnitedHealthcare | $254 - $341 | 140% |
| Medicaid / KanCare | $341 | 188% |
| Humana | $341 | 188% |
Consumer Guidance & Cost Commentary
For a psychiatric evaluation at Grisell Memorial Hospital in Ransom, KS, the facility's negotiated rates range from $159 to $341 depending on your specific insurance plan. While the median amount paid by insurers is $341, the cash price is $324, meaning paying out-of-pocket can sometimes be more economical than using insurance, especially if your plan has a high deductible. It is important to note that while the facility is in-network for Blue Cross Blue Shield, UnitedHealthcare, Medicaid/KanCare, and Humana, the actual amount you owe depends on your individual plan's negotiated rates, which vary between $159 and $341.
When comparing pricing against federal standards, the facility's gross charge of $341 is 1.6 times the Medicare benchmark of $181.34. This markup is typical for commercial billing, as negotiated rates often include administrative costs and risk premiums that exceed the base Medicare rate. To potentially lower your final bill, you should ask the hospital about prompt-pay discounts, which can reduce the total cost by 20% to 50% if you settle the account upfront. Additionally, if you receive an itemized bill, review it carefully to ensure no services were double-billed or unbundled, as over 80% of hospital bills contain errors that can be corrected through a formal audit.