CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Nationwide Children's Hospital

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90791
  • Insurance Median: $340
  • Cash Discount Price: $378
  • vs. Medicare Baseline: 1.87x Medicare
The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Nationwide Children's Hospital is $340. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $378. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.87x the Medicare baseline. Located in 700 Children's Drive, Columbus, OH.
Cash / Self-Pay
$378

Average discount available for prompt cash payment at this facility.

Insurance Median
$340

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: $378 (208%)
Insurance Median: $340 (187%)
Cash: $378 (208% of Medicare)
Ins. Median: $340 (187% 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
Amerihealth $124 - $266 68%
Bchp $124 - $266 68%
Blue Cross Blue Shield $124 - $420 68%
Caresource $124 - $272 68%
Humana $124 - $418 68%
Molina $124 - $266 68%
UnitedHealthcare $124 - $418 68%
Aetna $142 - $418 78%
Tricare $155 85%
Mmo $302 - $414 167%
Cigna $315 - $414 174%
Front Path Health Coalition $315 - $414 174%
Ohc $315 - $409 174%
Ohg $315 - $396 174%
Ohio Ppo Connect $315 - $409 174%
Osu $315 - $409 174%
The Health Plan $315 - $422 174%
Ahpo $340 - $414 187%
Unicare $344 - $418 190%
Emerald Health $355 - $431 196%
First Health $355 - $431 196%
Phcs $355 - $431 196%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 700 Children's Drive, Columbus, OH 43205
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens