CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Nationwide Children's Hospital Toledo, LLC

Billing Code: 90791 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$168

about 0.9× the $181 Medicare rate · typically $167–$190

modeled estimate · not a bill or quote

What this hospital charges insurers

$190

About the fair price

about $22 over the fair price · 1.0× Medicare

Medicare pays $181 Fair price $168 This hospital $190 Cash price $203 Hospital's list price $339

How we calculate the fair BaseRate →

How this hospital compares to other OH hospitals

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

Cheapest $110 Priciest $190

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

A fair price for a Psychiatric evaluation (first visit) is about $168 (about 0.9× the $181 Medicare rate). Nationwide Children's Hospital Toledo, LLC charges insurers about $190, or about $203 in cash — about the fair price. Located in Toledo, OH.

What each insurance company pays

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

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

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser 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	$80 - $213	44%
Blue Cross Blue Shieldmajor	$142 - $198	78%
Aetnamajor	$131	72%
Cignamajor	$235 - $339	130%
Humanamajor	$198	109%
AmeriHealth	$81 - $198	45%
CareSource	$79 - $190	44%
Molina	$181 - $196	100%
Paramount	$137	76%
+ 5 smaller / regional plans	$85 - $399

Government programs also on file: Military & VA.

Excludes 2 rental-network / third-party entries (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 203), 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 Nationwide Children's Hospital Toledo, LLC 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 Nationwide Children's Hospital Toledo, LLC

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

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