Psychiatric evaluation (first visit)
Facility: Girard Medical Center
Billing Code: 90791 (CPT)
- CPT Billing Code: 90791
- Insurance Median: $86
- Cash Discount Price: $148
- vs. Medicare Baseline: 0.47x 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 | $86 - $169 | 47% |
| Ambetter / Centene | $86 | 47% |
| Aetna | $86 - $430 | 47% |
| Medicare (plans) | $86 | 47% |
| Humana | $86 | 47% |
| Kansas Superior Select-All Plans | $86 | 47% |
| UnitedHealthcare | $86 - $234 | 47% |
| Multiplan-All Plans | $228 | 126% |
| Uhhis-All Plans | $234 | 129% |
Consumer Guidance & Cost Commentary
For a psychiatric evaluation at Girard Medical Center in Girard, KS, the negotiated rates for in-network insurance plans range from $86 to $430, with a median paid amount of $86. This facility is a Critical Access Hospital owned by a government hospital district, and its pricing aligns closely with the state average, as the median negotiated rate matches the reported state median of $86. While the facility's cash price of $148 is higher than the negotiated insurance rates, patients with high-deductible plans should consider paying cash upfront, as the cash price is still lower than the maximum negotiated rate of $430 seen with Aetna. It is important to verify your specific plan's allowed amount before scheduling, as in-network rates can vary significantly between payers even within the same state.
To ensure you are receiving the best possible price, you should request a prompt-pay discount if you choose to pay out-of-pocket, as hospitals often offer reductions of 20% to 50% for upfront payments to bypass costly insurance billing cycles. Additionally, because this is a government-owned facility, you may be eligible for self-pay or prompt-pay discounts that are not automatically applied when insurance is on file. If you receive a bill, always request a full itemized statement to review every CPT code and unit cost, as over 80% of hospital bills contain errors such as double-billing or unbundled charges. Comparing your final cost to the Medicare benchmark of $181.34 provides a clear view of the facility's pricing structure, ensuring you understand the true cost relative to federal standards rather than the inflated chargemaster list price.