CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Pine Rest Christian Mental Health Services

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90791
Insurance Median: $139
Cash Discount Price: $206
vs. Medicare Baseline: 0.77x Medicare

The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Pine Rest Christian Mental Health Services is $139. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $206. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 0.77x the Medicare baseline. Located in 300 - 68Th Street, Se, Grand Rapids, MI.

Cash / Self-Pay

$206

Average discount available for prompt cash payment at this facility.

Insurance Median

$139

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: $206 (114%)

Insurance Median: $139 (77%)

Cash: $206 (114% of Medicare)

Ins. Median: $139 (77% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Perspectives [1191]	$65	36%
Bensinger Dupont [1179]	$70	39%
Medicaid / KanCare	$71 - $115	39%
UnitedHealthcare	$71 - $139	39%
Human Mgmt/Health Advocate [1189]	$75	41%
Resolutions Eap [1211]	$75	41%
Blue Cross Blue Shield	$80 - $225	44%
Aetna	$94 - $226	52%
Champva [1117]	$110 - $169	61%
Humana	$110 - $191	61%
Medicare (plans)	$110 - $169	61%
Molina [1156]	$110 - $169	61%
Tricare	$110 - $169	61%
Veterans Administration [1174]	$110 - $169	61%
Cigna	$115 - $131	63%
Golden Rule [1131]	$121 - $139	67%
Healthscope Benefits [1140]	$121 - $139	67%
Ubh [1167]	$121 - $139	67%
Beacon/Carelon Behavioral Health [1198]	$132 - $160	73%
Compsych [1122]	$132 - $151	73%
Asr Physicians Care Health Plan [1160]	$145 - $174	80%
Hap Ppo/Health Alliance Plan [1134]	$145 - $174	80%
Behavioral Health Systems [1115]	$160 - $201	88%
University Of Michigan Health Plan Comm [1159]	$166 - $221	92%
University Of Michigan Health Plan [1205]	$166 - $221	92%
Cofinity [1120]	$170 - $226	94%
Geha [1129]	$170 - $226	94%
Meritain Health Plan [1153]	$170 - $226	94%
Blue Care Network [1000]	$174 - $196	96%
Ambetter / Centene	$175	97%
Mclaren Health Plan [1149]	$181	100%
Manistee Benzie County Cmh [3526]	$192	106%
Priority Health [1300]	$216 - $259	119%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $206.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 90791.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Pine Rest Christian Mental Health Services is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 90791.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.