CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: The Children's Mercy Hospital

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90791
  • Insurance Median: $254
  • Cash Discount Price: $214
  • vs. Medicare Baseline: 1.40x Medicare
The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at The Children's Mercy Hospital is $254. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $214. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.40x the Medicare baseline. Located in 2401 Gillham Road, Kansas City, MO.
Cash / Self-Pay
$214

Average discount available for prompt cash payment at this facility.

Insurance Median
$254

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: $214 (118%)
Insurance Median: $254 (140%)
Cash: $214 (118% of Medicare)
Ins. Median: $254 (140% 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
UnitedHealthcare $143 - $258 79%
Healthlink $152 84%
Healthy Blue $152 - $222 84%
Medicaid / KanCare $154 85%
Health Midwest Comprehensive Care $204 112%
Wppa Providrs Care $207 114%
American Healthcare Alliance $213 117%
Home State Health $222 122%
Humana $232 128%
Orscheln $234 129%
Nebraska Furniture Mart $235 130%
Blue Cross Blue Shield $254 140%
Medica $260 143%
Cigna $266 147%
Wellfit/Centrus $283 156%
Centivo $291 160%
Mercy Health $326 180%
Coxhealth Network $330 182%
National Preferred Provider Network $392 216%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2401 Gillham Road, Kansas City, MO 64108
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens