Psychiatric evaluation (first visit)
Facility: Children'S Mercy South
Billing Code: 90791 (CPT)
- CPT Billing Code: 90791
- Insurance Median: $254
- Cash Discount Price: $214
- vs. Medicare Baseline: 1.40x 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 |
|---|---|---|
| UnitedHealthcare | $143 - $258 | 79% |
| Healthlink | $152 | 84% |
| Healthy Blue | $152 - $222 | 84% |
| Medicaid / KanCare | $154 | 85% |
| Health Midwest Comprehensive Care | $204 | 112% |
| Wppa Providrs Care | $207 | 114% |
| American Healthcare Alliance | $213 | 117% |
| Home State Health | $222 | 122% |
| Humana | $232 | 128% |
| Orscheln | $234 | 129% |
| Nebraska Furniture Mart | $235 | 130% |
| Blue Cross Blue Shield | $254 | 140% |
| Medica | $260 | 143% |
| Cigna | $266 | 147% |
| Wellfit/Centrus | $283 | 156% |
| Centivo | $291 | 160% |
| Mercy Health | $326 | 180% |
| Coxhealth Network | $330 | 182% |
| National Preferred Provider Network | $392 | 216% |
Consumer Guidance & Cost Commentary
For a psychiatric evaluation (first visit) at Children's Mercy South in Overland Park, KS, the facility's cash price of $214.00 is significantly lower than the gross charge of $446.00. While the facility is a voluntary non-profit, patients should be aware that commercial insurance negotiated rates often exceed cash prices due to administrative overhead and contract structures. For instance, the median negotiated rate across payers is $254.00, and the highest allowed amount listed is $392.00 by the National Preferred Provider Network. This dynamic suggests that individuals with high-deductible plans or those who have not yet met their deductible may save money by paying the cash price directly, provided they confirm the facility accepts their specific insurance plan.
To avoid unexpected costs, patients should verify their coverage status and explicitly request "self-pay" or "prompt-pay" discounts before scheduling, as these can reduce the final bill by 20% to 50%. If a patient does receive a bill from an out-of-network provider or services rendered at an in-network facility, they may be entitled to protections under the No Surprises Act, which bans balance billing for emergency and non-emergency care. Furthermore, since over 80% of hospital bills contain errors, patients should always demand a full, itemized CPT-coded statement rather than accepting a summary invoice, ensuring they can identify unbundled codes or services not rendered before making any payment.