CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Southwest General Health Center

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90791
  • Insurance Median: $193
  • Cash Discount Price: $362
  • vs. Medicare Baseline: 1.06x Medicare
The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Southwest General Health Center is $193. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $362. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.06x the Medicare baseline. Located in 18697 Bagley Road, Middleburg Heights, OH.
Cash / Self-Pay
$362

Average discount available for prompt cash payment at this facility.

Insurance Median
$193

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: $362 (200%)
Insurance Median: $193 (106%)
Cash: $362 (200% of Medicare)
Ins. Median: $193 (106% 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
Medical Mutual $64 - $66 35%
Medical Mutual-Ohio $64 - $205 35%
Buckeye $77 - $201 42%
Caresource $77 - $187 42%
Humana $77 - $205 42%
Molina $77 - $201 42%
UnitedHealthcare $77 - $261 42%
Amerihealth Caritas $80 - $187 44%
Healthsmart $155 85%
Health Design Plus $179 99%
Blue Cross Blue Shield $187 - $273 103%
Clarity Health $193 106%
Healthspan $193 106%
Valor Health $205 113%
Healthsmart Preferred $217 120%
Ohio Health Choice Plus $234 129%
Aetna $261 144%
Summacare $261 144%
Cigna $264 146%
Coventry $333 184%
First Health $333 184%
Ohio Health Choice $373 206%
Private Healthare Systems $386 213%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 18697 Bagley Road, Middleburg Heights, OH 44130
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals