CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Cleveland Clinic

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90791
  • Insurance Median: $197
  • Cash Discount Price: $214
  • vs. Medicare Baseline: 1.09x Medicare
The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Cleveland Clinic is $197. 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 1.09x the Medicare baseline. Located in 9500 Euclid Avenue, Cleveland, OH.
Cash / Self-Pay
$214

Average discount available for prompt cash payment at this facility.

Insurance Median
$197

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: $197 (109%)
Cash: $214 (118% of Medicare)
Ins. Median: $197 (109% 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 $73 - $885 40%
Paramount $79 - $186 44%
Buckeye $81 - $190 45%
Caresource $81 - $181 45%
United $83 - $417 46%
Amerihealth $85 47%
Molina $85 - $190 47%
Cc Ehp $91 - $269 50%
Summacare $92 - $265 51%
Oscar $99 - $369 55%
Cigna $136 - $416 75%
Aetna $142 - $1,383 78%
Blue Cross Blue Shield $142 - $369 78%
Devoted Health $142 - $149 78%
Humana $142 - $280 78%
The Health Plan $142 - $761 78%
Upmc $142 - $830 78%
Valor $142 - $149 78%
Amish Community Aid Plan $148 - $622 82%
Communicare $149 - $156 82%
Mmo $149 - $968 82%
Perennial Health $153 - $161 84%
Pphp $153 - $164 84%
Zing Health $156 - $164 86%
Ohcp $160 - $538 88%
Aultcare $161 - $595 89%
Omas $164 - $692 90%
United Bh $167 - $317 92%
Ohio Healthy $178 - $553 98%
Healthsmart $181 - $761 100%
Php $197 109%
Phphi $197 - $830 109%
Clarity Health $214 - $899 118%
Gms $230 - $968 127%
Medical Benefit Corp $230 127%
Parkview Health Plan $230 127%
Quality Care Partners $230 - $968 127%
Consociate Health $247 - $1,037 136%
Community Health Alliance $263 145%
Frontpath $296 163%
Managed Care Services $296 163%
Multiplan $296 - $1,245 163%
Tertiary Care Network $296 163%
Three Rivers $296 - $1,245 163%
Usa Managed Care $1,245 687%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 9500 Euclid Avenue, Cleveland, OH 44195
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals