CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Mercy Health Saint Mary's

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90791
  • Insurance Median: $197
  • Cash Discount Price: $176
  • vs. Medicare Baseline: 1.09x Medicare
The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Mercy Health Saint Mary's is $197. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $176. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.09x the Medicare baseline. Located in 200 Jefferson Avenue Se, Grand Rapids, MI.
Cash / Self-Pay
$176

Average discount available for prompt cash payment at this facility.

Insurance Median
$197

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$181.34

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $181.34 (100%)
Cash / Self-Pay: $176 (97%)
Insurance Median: $197 (109%)
Cash: $176 (97% of Medicare)
Ins. Median: $197 (109% of 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.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Aetna $120 - $288 66%
Champva $121 67%
Tricare $121 67%
Triwest Health Alliance $121 67%
Us Family Health Plan $121 67%
Veterans Eval Services $121 67%
Ally Align Care Adv $125 - $166 69%
American Health Advantage Of Idaho $125 - $166 69%
American Health Plan $125 - $166 69%
Aurora Special Needs $125 - $166 69%
Blue Care Network Advantage $125 - $166 69%
Blue Cross Blue Shield $125 - $184 69%
Blue Shield - De (Highmark) Medciare Advantage $125 - $166 69%
Care Dimensions $125 - $166 69%
Care Improvement Plus $125 - $166 69%
Care Resources Pace $125 - $166 69%
Careplus Health Plans $125 - $166 69%
Cca Senior Care Options $125 - $166 69%
Central Valley Medical Services Corp Pace $125 - $166 69%
Champion Health Plan Mcr Advantage $125 - $166 69%
Cigna $125 - $206 69%
Clear Spring Health $125 - $166 69%
Clover Health $125 - $166 69%
Commonwealth Care Alliance $125 - $166 69%
Community Pace At Home $125 - $166 69%
Eddy Senior Care-Pace $125 - $166 69%
Eddy Seniorcare Pace $125 - $166 69%
Elementcare $125 - $166 69%
Evercare $125 - $166 69%
Everence $125 - $166 69%
Gateway Health Plan $125 - $166 69%
Genesys Pace Of Genesee County $125 - $166 69%
Georgia Health Advantage $125 - $166 69%
Gold Advantage $125 - $166 69%
Gpa Croell Redi Mix $125 - $166 69%
Health America Advantra $125 - $166 69%
Highmark Health Options Dual Plan $125 - $166 69%
Hope Select Pace $125 - $166 69%
Horizon Nj Total Care $125 - $166 69%
Hudson Headwaters Pace $125 - $166 69%
Humana $125 - $271 69%
Huron Valley Pace $125 - $166 69%
Innovative Integrated Health Community Plans $125 - $166 69%
Iowa Health Advantage $125 - $166 69%
Johns Hopkins Advantage Md $125 - $166 69%
Lasso Healthcare Msa $125 - $166 69%
Life St Marys Pace $125 - $166 69%
Lifecircles Pace $125 - $166 69%
Longevity Health Plan $125 - $166 69%
Martins Point Generations Advantage $125 - $166 69%
Mass General Brigham Mcr Adv $125 - $166 69%
Medicare (plans) $125 - $174 69%
Medipak Advantage $125 - $166 69%
Mercy Life $125 - $166 69%
Mercyone Cedar Valley $125 - $166 69%
Meridian Complete $125 - $166 69%
Michigan Complete Health $125 - $166 69%
Nascentia Health Plus $125 - $166 69%
New Centry Health Careplus $125 - $166 69%
Osu Prime Care Advantage $125 - $166 69%
Pace Cny $125 - $166 69%
Pace Iowa Immanuel Pathways $125 - $166 69%
Pace Of Southwest Michigan $125 - $170 69%
Pace Southeast $125 - $166 69%
Pace-Trinity Health $125 - $166 69%
Peak Pace Solutions $125 - $166 69%
Perennial Advantage $125 - $166 69%
Preferred Care Partners $125 - $166 69%
Presbyterian Senior Plan $125 - $166 69%
Provider Partners Health Plan Of Illinois $125 - $166 69%
Provider Partners Health Plan Of Indiana $125 - $166 69%
Pruitthealth Premier $125 - $166 69%
Reliance Community Care Partners Care Resources Pace $125 - $166 69%
Rx Allwin $125 - $166 69%
Rx Grane Grnmedd $125 - $166 69%
Rx Retiree Rx Care $125 - $166 69%
Scan Health Plan Mcr Ipa Meritage Oon $125 - $166 69%
Secure Horizons Ma Pffs $125 - $166 69%
Serenity Pace $125 - $166 69%
Siouxland Pace $125 - $166 69%
Solis Health Plans $125 - $166 69%
Sunnyview-Pace Finance Dept $125 - $166 69%
Texan Plus $125 - $166 69%
The Health Plan $125 - $197 69%
Thome Pace $125 - $166 69%
Todays Options $125 - $166 69%
Tribute Health Plans $125 - $166 69%
Um Health Advantage $125 - $166 69%
Union Health Service $125 - $166 69%
UnitedHealthcare $125 - $271 69%
Welbe Health $125 - $166 69%
Wellmed $125 - $166 69%
Align Senior Care $127 - $170 70%
Veterans Administration $127 - $170 70%
Bcn Domestic $131 72%
Blue Benefit Administrators Of Massachusetts $131 - $184 72%
Blue Care Network $131 - $213 72%
Blue Distinction Transplant $131 - $184 72%
Blue Shield - Ca $131 - $184 72%
Blue Shield - Id (Regence) $131 - $184 72%
Blue Shield - Ny Highmark Northeastern $131 - $184 72%
Blue Shield - Ny Highmark Western $131 - $184 72%
Blue Shield - Pa (Highmark) $131 - $184 72%
Blue Shield - Wa (Regence) $131 - $184 72%
Health Choices $131 - $206 72%
Kaiser Domestic $131 72%
Asr Health Benefits $137 - $172 76%
Cca - Zing Health $137 - $155 76%
Medicaid / KanCare $137 - $340 76%
Access Health $142 - $190 78%
Longevity Ipa Of Michigan Llc Health Plan Isnp $143 - $191 79%
Wc Accident Fund $148 - $241 82%
Wc Advantage $148 - $241 82%
Wc Aig $148 - $241 82%
Wc Allied $148 - $241 82%
Wc Amerisure $148 - $241 82%
Wc Amtrust $148 - $241 82%
Wc Asu Risk Mgt $148 - $241 82%
Wc Berkley Admin $148 - $241 82%
Wc Broadspire $148 - $241 82%
Wc Bunch & Associates $148 - $241 82%
Wc Ccmsi $148 - $241 82%
Wc Emc Insurance Company $148 - $241 82%
Wc Esis $148 - $241 82%
Wc Fcci $148 - $241 82%
Wc Federated $148 - $241 82%
Wc Gallagher Bassett $148 - $241 82%
Wc Genex Care For Ohio $148 - $241 82%
Wc Guard Insurance Company $148 - $241 82%
Wc Hartford $148 - $241 82%
Wc Liberty Mutual $148 - $241 82%
Wc Meijers $148 - $241 82%
Wc Michigan $148 - $241 82%
Wc Mitchell Frankenmuth $148 - $241 82%
Wc Pma $148 - $241 82%
Wc Sedgwick $148 - $241 82%
Wc Sentry $148 - $241 82%
Wc Travelers $148 - $241 82%
Wc Tristar $148 - $241 82%
Wc Walmart $148 - $241 82%
Wc Zurich $148 - $241 82%
Nomi Health $152 - $263 84%
Us Health And Life $154 - $206 85%
Acs Benefit Services $156 86%
Allied Benefit Systems $156 - $197 86%
Claimchoice Adminstrators $156 - $197 86%
Consociate $156 - $197 86%
Cypress Benefit Administrators $156 - $197 86%
Forest County Potawatomi $156 - $197 86%
Health Smart $156 - $197 86%
Healthgram $156 - $197 86%
Healthscope $156 - $197 86%
Secureone Preferred United Plans $156 - $197 86%
Sisco Benefits $156 - $197 86%
Trustmark Small Business Benefits $156 - $197 86%
Unified Group Services $156 - $197 86%
Webtpa $156 - $197 86%
Hap $157 - $210 87%
Health Partners $157 87%
Tufts Health Plan $157 87%
Geha $159 - $206 88%
Albany County Correctional Facility $170 94%
Ambetter / Centene $170 94%
Amish Mennonite $170 94%
Ascension St. Vincent Public Safety Medical $170 94%
Bccp $170 94%
Bmc Healthnet $170 94%
Breast Grant-Connecticut $170 94%
Broward County Dept Of Health $170 94%
California Health And Wellness $170 94%
Cardinal Innovations Lme $170 94%
Care Connections Of Northern Iowa $170 94%
Care Oregon Ohp $170 94%
Cencal Health Plan $170 94%
Cenpatico $170 94%
Chhuny $170 94%
Childrens Comm Health Plan $170 94%
Childrens Medical Services Title 19 $170 94%
City Of Philadelphia $170 94%
Cmh Allegan County $170 - $271 94%
Cmh Ausable Valley $170 - $271 94%
Cmh Barry County $170 - $271 94%
Cmh Bay-Arenac County $170 94%
Cmh Berrien County $170 - $271 94%
Cmh Cass County $170 - $271 94%
Cmh Central Mi County $170 94%
Cmh Clinton-Eaton-Ingham County $170 - $271 94%
Cmh Detroit Wayne Integrated Health Network $170 94%
Cmh Genesee County $170 94%
Cmh Ionia County $170 94%
Cmh Jackson County/Lifeways $170 94%
Cmh Kalamazoo $170 - $271 94%
Cmh Kent County $170 - $271 94%
Cmh Lenawee County $170 - $271 94%
Cmh Livingston County $170 94%
Cmh Macomb $170 94%
Cmh Misc $170 - $271 94%
Cmh Monroe County $170 - $271 94%
Cmh Montcalm County $170 - $271 94%
Cmh Muskegon County $170 - $271 94%
Cmh Newaygo County $170 - $271 94%
Cmh North Country $170 - $271 94%
Cmh Northern Lakes County $170 - $271 94%
Cmh Oakland County $170 94%
Cmh Ottawa County $170 - $271 94%
Cmh Van Buren County $170 - $271 94%
Cmh Washtenaw County $170 94%
Cmh Wayne County/Carelink $170 94%
Cmh Wayne Cty/Com Liv Svcs $170 94%
Cmh West Mi County $170 - $271 94%
Community Benefit Health $170 94%
Community Care Behavorial Health $170 94%
Community Care Partners $170 94%
Community Health Choice $170 94%
Connections Csp $170 94%
County Coroner $170 94%
County Funding Generic $170 94%
Covid19 Hrsa Uninsured Testing And Treatment Fund $170 94%
Dean Wi Badgercare $170 94%
Delaware County Department Of Health $170 94%
Delaware First Health $170 94%
Delta Dental Nj $170 94%
Dph Tb Program $170 94%
Dscc $170 94%
Eastpointe Lme $170 94%
Family Health Network $170 94%
Freedom First Healthcare $170 94%
Fresno County Ccs $170 94%
Ghc Scw Wi Badgercare $170 94%
Harbor Health $170 94%
Health Safety Net $170 94%
Healthy Blue Ne $170 94%
Hennepin Health $170 94%
Id County Ada $170 94%
Id County Canyon $170 94%
Id County Cat Fund $170 94%
Id County Other $170 94%
Id County Payette $170 94%
Idaho Dept Health And Wellfare $170 94%
Idaho Womens Health Check $170 94%
Indiana Breast Cervical Cancer $170 94%
Inland Empire Health Plan $170 94%
Intercommunity Health Ohp $170 94%
Iowa Total Care $170 94%
Jai Medical System $170 94%
Kern Family Health Plan $170 94%
Keystone First $170 94%
Keystone First Chip $170 94%
La Care Health Plan $170 94%
Lakeland Care Inc $170 94%
Managed Health Services - Indiana $170 94%
Maryland Breast & Cervical Program $170 94%
Maryland Healthy Smiles - Scion Dental $170 94%
Maryland Physicians Care $170 94%
Massachusetts Behavioral Health Partnership $170 94%
Mdwise $170 94%
Medi-Cal $170 94%
Medi-Cal Healthnet $170 94%
Medical Mutual $170 - $197 94%
Medstar Dc Healthy Family $170 94%
Medstar Md Health Choice $170 94%
Meritain $170 - $288 94%
Mo Home State Health Plan $170 94%
Molina Centennial Care $170 94%
Nascentia Health Options $170 94%
Nebraska Total Care $170 94%
New York Cancer Services Program $170 94%
Nextlevel Health $170 94%
Oregon Screenwise $170 94%
Paramount Advantage $170 94%
Parkland Community Health Plan $170 94%
Partners Behavioral Lme $170 94%
Peach State Healthplan $170 94%
Philadelphia County Funding $170 94%
Preferred One $170 - $197 94%
Presbyterian Centennial Care $170 94%
Prestige Health Choice $170 94%
Priority Partners $170 94%
Robert F Sing Program $170 94%
Rx 340B Pass Along $170 94%
Rx Assistance/Rx Manufacturer Assistance 0 Copay $170 94%
Rx Medi-Cal $170 94%
Rx Meridian Rx $170 94%
Ryan White Florida Mssrp $170 94%
Sandhills Center Lme $170 94%
Screening For Life $170 94%
St Joseph County Hlth Dpt $170 94%
Stephenson Cty Health $170 94%
Sunshine State Health Plan $170 94%
Superior Health $170 94%
Tenncare $170 94%
Texas Children'S Health Plan $170 94%
Trillium Community Ohp $170 94%
Tufts Health Public Plans $170 94%
Vaya Health Lme $170 94%
Washtenaw Health Plan $170 94%
Wellsense Health Plan $170 94%
Wi Womens Wellness $170 94%
1199 National Benefit Fund $172 - $229 95%
Allied National Global Care $172 - $229 95%
Asrm - Reliance Standard Life Insurance $172 - $229 95%
Christian Care Ministry $172 - $229 95%
Dean Health $172 - $229 95%
Fallon Health $172 - $229 95%
Family Life Insurance Company $172 - $229 95%
International Benefit Administrators $172 - $229 95%
Lifetime Benefit Solutions $172 - $229 95%
Manhattan Life $172 - $229 95%
Molina Marketplace $172 - $229 95%
Multiplan $172 - $229 95%
Mvp $172 - $229 95%
Oscar $172 - $229 95%
Pai $172 - $229 95%
Pan-American Life $172 - $229 95%
Phcs $172 - $229 95%
Trinity Health Share $172 - $229 95%
Wellpath $172 - $229 95%
American Postal Workers Secondary $175 - $206 97%
Varipro $176 - $195 97%
Caresource $177 98%
Partners Direct Health - Brio $184 - $246 101%
Priority Health $186 - $359 103%
Acclaim $197 - $206 109%
Administrative Concepts $197 - $206 109%
Allegeant $197 - $206 109%
Ameriben $197 - $206 109%
American Family $197 - $206 109%
American Healthcare Alliance $197 - $206 109%
American National $197 109%
American Republic $197 - $206 109%
Amerihealth $197 - $206 109%
Aultcare $197 - $206 109%
Automated Benefit Services $197 - $206 109%
Auxiant $197 - $206 109%
Benefit Administrative Systems,Llc $197 - $206 109%
Boon Chapman $197 - $206 109%
Cam Administrative Services $197 - $206 109%
Christian Brother Services $197 - $206 109%
Christian Brothers Holy Cross $197 - $206 109%
Claimdoc $197 - $263 109%
Comprehensive Benefits $197 - $206 109%
Continental Life Insurance $197 - $206 109%
Coventry $197 - $215 109%
Custom Benefit Administrators $197 - $206 109%
Employee Benefit Concepts $197 - $206 109%
Employee Benefit Management $197 - $206 109%
Enterprise Group Planning $197 - $206 109%
First Health $197 - $215 109%
Freedom Life Insurance Company $197 - $206 109%
Group Administrators $197 - $206 109%
Group Marketing Services $197 - $206 109%
Group Pension Administrators $197 - $198 109%
Guardian $197 - $206 109%
Health America $197 - $206 109%
Healthcare Management Admin $197 109%
Healthez $197 - $206 109%
Insight $197 - $206 109%
Jfp Benefit Management $197 - $206 109%
Jp Farley Corporation $197 - $206 109%
Kent County Jail $197 - $263 109%
Key Benefit Administrator $197 - $206 109%
Liberty Union Life Assurance Co $197 - $206 109%
Lucent Health $197 - $206 109%
Luminare Health $197 - $206 109%
Luminare Health (Detroit) $197 - $206 109%
Magnacare $197 109%
Medben $197 - $206 109%
Medcost $197 - $206 109%
Muskegon County Jail $197 - $263 109%
Mutual Health Services $197 - $206 109%
Mutual Of Omaha $197 - $206 109%
Ncas $197 - $206 109%
Nippon Life Ins $197 - $206 109%
Nova $197 - $206 109%
Painters Union Insurance Fund $197 - $206 109%
Physicians Mutual $197 - $206 109%
Plumbers Local 98 Insurance Fund $197 - $206 109%
Prairie States $197 - $206 109%
Primary Physician Care $197 - $206 109%
Professional Benefit Administrators $197 - $206 109%
Siho Insurance Services $197 109%
The Loomis Company $197 - $206 109%
Unicare $197 - $206 109%
Valenz $197 - $206 109%
Western & Southern Financial Group $197 - $206 109%
Wps $197 - $206 109%
Ghc Scw $198 109%
Medi Share $198 109%
Paramount Hmo $198 109%
Intercare $206 - $340 114%
U Of M Health Plan $206 - $300 114%
Andrie Inc $215 - $253 119%
East Greenbush Central School District $215 - $253 119%
Genex Wc $215 - $253 119%
Healthsmart Workers Comp $215 - $253 119%
Jag Source $215 - $253 119%
New York State Insurance Fund $215 - $253 119%
Njm Insurance Group $215 - $253 119%
Rx Heatlhcomp $215 - $253 119%
Rx Restat $215 - $253 119%
Rx Saif Opdp Wc $215 - $253 119%
Rx Worker'S Comp $215 - $253 119%
Wc Ace $215 - $253 119%
Wc Acs Federal Employees $215 - $253 119%
Wc Acuity $215 - $253 119%
Wc Aegis $215 - $253 119%
Wc Aims $215 - $253 119%
Wc Alaska National Ins $215 - $253 119%
Wc Align Network $215 - $253 119%
Wc Am Trust N America $215 - $253 119%
Wc American Claims Mgmt $215 - $253 119%
Wc Benetech $215 - $253 119%
Wc Broward County $215 - $253 119%
Wc California State Comp Ins $215 - $253 119%
Wc California State Ins Fund $215 - $253 119%
Wc Capitol Area Health Consortium $215 - $253 119%
Wc Chartis $215 - $253 119%
Wc Chubb $215 - $253 119%
Wc Cirma $215 - $253 119%
Wc City Of Albany $215 - $253 119%
Wc City Of Sioux City $215 - $253 119%
Wc Claims Mgmt Inc $215 - $253 119%
Wc Cna $215 - $253 119%
Wc Comp One Admin C/O Manageability $215 - $253 119%
Wc Compone Admin $215 - $253 119%
Wc Corvel $215 - $253 119%
Wc Ct Healthcare Trust $215 - $253 119%
Wc Donegal Insurance Group $215 - $253 119%
Wc Employee Mutual $215 - $253 119%
Wc Enablecomp $215 - $253 119%
Wc Encore Health Network $215 - $253 119%
Wc Erie $215 - $253 119%
Wc Evolutions $215 - $253 119%
Wc Fed Ex $215 - $253 119%
Wc Federal Black Lung $215 - $253 119%
Wc Finley Occupational Health $215 - $253 119%
Wc First Agency/Occunet $215 - $253 119%
Wc Ford Motor $215 - $253 119%
Wc Fresno Unified Emp $215 - $253 119%
Wc General Motors $215 - $253 119%
Wc Generic $215 - $253 119%
Wc Great West Casualty $215 - $253 119%
Wc Guarantee Insurance $215 - $253 119%
Wc Hab $215 - $253 119%
Wc Hastings $215 - $253 119%
Wc Health Management $215 - $253 119%
Wc Heritage Summit $215 - $253 119%
Wc Hireright $215 - $253 119%
Wc Horizon $215 - $253 119%
Wc Icw Group $215 - $253 119%
Wc Idaho State Ins Fund $215 - $253 119%
Wc Intercare Insurance $215 - $253 119%
Wc Intermountain $215 - $253 119%
Wc Johns Eastern $215 - $253 119%
Wc Kemberton $215 - $253 119%
Wc Key Ins & Benefit Solutions $215 - $253 119%
Wc Mac Risk Management $215 - $253 119%
Wc Massachusetts $215 - $253 119%
Wc Mdia $215 - $253 119%
Wc Meadowbrook Claim $215 - $253 119%
Wc Medical Administrators $215 - $253 119%
Wc Memic $215 - $253 119%
Wc Mercy Workcare $215 - $253 119%
Wc Michigan Millers Mutual $215 - $253 119%
Wc Mra $215 - $253 119%
Wc Nationwide $215 - $253 119%
Wc Nca Comp $215 - $253 119%
Wc New York $215 - $253 119%
Wc New York Special Funds $215 - $253 119%
Wc North American Rishces $215 - $253 119%
Wc Northeast Health $215 - $253 119%
Wc Notre Dame $215 - $253 119%
Wc Novanet $215 - $253 119%
Wc O'Hara Corp $215 - $253 119%
Wc Occ Health Allen $215 - $253 119%
Wc Ohio Bureau $215 - $253 119%
Wc One Call Medical $215 - $253 119%
Wc Paradigm $215 - $253 119%
Wc Peerless $215 - $253 119%
Wc Praxis Health Network $215 - $253 119%
Wc Price Chopper $215 - $253 119%
Wc Procura Management $215 - $253 119%
Wc Qualcare $215 - $253 119%
Wc Quiktrip $215 - $253 119%
Wc Reny Company $215 - $253 119%
Wc Rev Claims $215 - $253 119%
Wc Risico $215 - $253 119%
Wc Rural Mutual $215 - $253 119%
Wc Saif Oregon $215 - $253 119%
Wc Secura $215 - $253 119%
Wc Sheakley Unicomp $215 - $253 119%
Wc Smile Lodge $215 - $253 119%
Wc Society $215 - $253 119%
Wc Srs $215 - $253 119%
Wc Taconic (Mro) $215 - $253 119%
Wc Taconic Farms $215 - $253 119%
Wc Triad Group $215 - $253 119%
Wc Troy Ny $215 - $253 119%
Wc Tyson $215 - $253 119%
Wc Unified Health Services $215 - $253 119%
Wc United Heartland $215 - $253 119%
Wc Us Dept Of Labor $215 - $253 119%
Wc Velocity $215 - $253 119%
Wc West Bend $215 - $253 119%
Wc West Bend Mutual/Argent $215 - $253 119%
Wc Winnebago Industries $215 - $253 119%
Wc Yankee Trails $215 - $253 119%
Wc York Risk $215 - $253 119%
Wc Zenith $215 - $253 119%
Magellan Behavioral Health $271 149%
Bcccp-Michigan $340 187%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 200 Jefferson Avenue Se, Grand Rapids, MI 49503
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals