Psychiatric evaluation (first visit)
Facility: Golden Valley Memorial Hospital
Billing Code: 90791 (CPT)
- CPT Billing Code: 90791
- Insurance Median: $161
- Cash Discount Price: $173
- vs. Medicare Baseline: 0.89x 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 |
|---|---|---|
| Home State Health | $143 | 79% |
| UnitedHealthcare | $143 - $274 | 79% |
| Aetna | $161 | 89% |
| Humana | $161 | 89% |
| Ambetter / Centene | $194 | 107% |
Consumer Guidance & Cost Commentary
For a psychiatric evaluation (first visit) at Golden Valley Memorial Hospital in Clinton, MO, the cash median charge is $173. This facility, operated by the Government - Hospital District or Authority, reports a gross charge of $288 and a median negotiated rate of $161 for this procedure. While the cash price is lower than the gross charge, patients should note that their specific insurance plan's negotiated rate could potentially exceed $173; for instance, UnitedHealthcare has a high-end negotiated rate of $274, which would make the cash price a significant savings if the patient's deductible has been met.
The Medicare benchmark for this service is $181.34, and the facility's cash rate is 0.9 times this benchmark, indicating the cash price is slightly below the federal baseline. Because commercial negotiated rates often include administrative overheads that push them higher than cash prices, patients with high-deductible plans may find paying the $173 cash rate more beneficial than using insurance coverage for this service. To secure the lowest possible amount, patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts, which can offer further reductions for upfront payment, and ensure they request a waiver of insurance submission to avoid automatic claims that might void any cash agreement.