CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: The Children's Mercy Hospital

Billing Code: 90791 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$171

about 0.9× the $181 Medicare rate · typically $116–$290

modeled estimate · not a bill or quote

What this hospital charges insurers

$244

Above the fair price

about $73 over the fair price · 1.3× Medicare

Medicare pays $181 Fair price $171 This hospital $244 Cash price $214 Hospital's list price $446

How we calculate the fair BaseRate →

How this hospital compares to other MO hospitals

Highest price of the 9 MO hospitals we have prices for — worth calling around.

Cheapest $156 Priciest $244

Black dot = this hospital, among the 9 MO hospitals with a price for this procedure. Full list below.

A fair price for a Psychiatric evaluation (first visit) is about $171 (about 0.9× the $181 Medicare rate). The Children's Mercy Hospital charges insurers about $244, or about $214 in cash — above the fair price. Located in Kansas City, MO.

This price is above the fair BaseRate — you may be able to pay less

Ask the hospital for the cash / self-pay price, check whether you qualify for financial assistance, or negotiate the bill down toward the fair price of about $171. Many patients pay well below the first number they’re quoted — the checklists below walk you through it.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

4 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Cigna✓ Humana AetnaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$143 - $258	79%
Blue Cross Blue Shieldmajor	$254	140%
Cignamajor	$266	147%
Humanamajor	$232	128%
Health Net	$330	182%
HealthLink	$152	84%
Medica	$260	143%
+ 10 smaller / regional plans	$152 - $326

Government programs also on file: Medicaid.

Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 214), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 90791.

Insurance Before you use insurance

Call your insurance company to confirm The Children's Mercy Hospital is in-network.
Ask your insurer whether prior approval is required for CPT code 90791.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at The Children's Mercy Hospital

Compare: Psychiatric evaluation (first visit) at other MO hospitals

Insurance negotiated median for the same procedure, sorted lowest first.