CMS Price Transparency Data
Psychiatric evaluation (first visit)
Facility: Mercy Hospital Springfield
Billing Code: 90791 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 90791
- Insurance Median: $229
- Cash Discount Price: $262
- vs. Medicare Baseline: 1.26x Medicare
The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Mercy Hospital Springfield is $229. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $262. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.26x the Medicare baseline. Located in 2115 S. Fremont Ave, Springfield, MO.
Cash / Self-Pay
$262
Average discount available for prompt cash payment at this facility.
Insurance Median
$229
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: $262 (144%)
Insurance Median: $229 (126%)
Cash: $262 (144% of Medicare)
Ins. Median: $229 (126% 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 |
|---|---|---|
| Medicaid / KanCare | $76 - $205 | 42% |
| Medica Contracted [320239] | $120 - $301 | 66% |
| Medica [20239] | $120 - $301 | 66% |
| Benefit Management Contracted [320052] | $122 - $200 | 67% |
| Health Systems Inc Contracted [320174] | $122 - $200 | 67% |
| Insurance System Inc Contracted [320465] | $122 - $200 | 67% |
| Ambetter / Centene | $124 - $204 | 68% |
| Home State Health Plan Contracted [320187] | $124 - $204 | 68% |
| Novasys Contracted [320285] | $124 - $204 | 68% |
| Administrative Payor Contracted [320005] | $137 - $250 | 76% |
| Evolutions Health Care Contracted [320124] | $137 - $225 | 76% |
| Point C Contracted [320238] | $137 - $376 | 76% |
| Point C [20238] | $137 - $225 | 76% |
| Blue Cross Blue Shield | $138 - $383 | 76% |
| Aetna | $152 - $250 | 84% |
| Medical Destinations Contracted [320242] | $152 - $250 | 84% |
| Mercy Benefit Admin Contracted [320251] | $152 - $301 | 84% |
| Workers Comp [20426] | $152 - $426 | 84% |
| Humana | $156 - $341 | 86% |
| United Medical Resources Contracted [320454] | $158 - $411 | 87% |
| First Health Contracted [320128] | $170 - $281 | 94% |
| Aither Health Contracted [320449] | $173 - $286 | 95% |
| Auxiant Contracted [320462] | $173 - $326 | 95% |
| Ebms Contracted [320493] | $173 - $286 | 95% |
| Edison Health Solutions Contracted [320502] | $173 - $286 | 95% |
| Healthlink Contracted [320179] | $173 - $401 | 95% |
| Imagine 360 Contracted [320494] | $173 - $286 | 95% |
| Reflect Health Contracted [320492] | $173 - $286 | 95% |
| Yuzu Health Contracted [320521] | $173 - $286 | 95% |
| 90 Degree Benefits Contracted [320436] | $182 - $301 | 100% |
| Federal Medical Center Contracted [320127] | $182 - $301 | 100% |
| Show-Me Health Administrators Contracted [320483] | $182 - $301 | 100% |
| Cigna | $210 - $386 | 116% |
| UnitedHealthcare | $233 - $636 | 128% |
| Multiplan Contracted [320270] | $234 - $386 | 129% |
| Private Health Care Systems Contracted [320320] | $234 - $386 | 129% |
| Compcare Of The Ozarks Contracted [320437] | $240 - $396 | 132% |
| American Healthcare Alliance Contracted [320020] | $243 - $401 | 134% |
| Qual Choice Contracted [320324] | $243 - $401 | 134% |
| Municipal Health Plan Contracted [320271] | $246 - $406 | 136% |
| Usa Managed Care Org Contracted [320429] | $268 - $441 | 148% |
| Ppo Plus Contracted [320310] | $274 - $451 | 151% |
| Medicare (plans) | $301 | 166% |