CMS Price Transparency Data
Psychiatric evaluation (first visit)
Facility: Hospital of Univ of Pennsylvania
Billing Code: 90791 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 90791
- Insurance Median: $298
- Cash Discount Price: $564
- vs. Medicare Baseline: 1.64x Medicare
The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Hospital of Univ of Pennsylvania is $298. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $564. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.64x the Medicare baseline. Located in 3400 Spruce St, Philadelphia, PA.
Cash / Self-Pay
$564
Average discount available for prompt cash payment at this facility.
Insurance Median
$298
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: $564 (311%)
Insurance Median: $298 (164%)
Cash: $564 (311% of Medicare)
Ins. Median: $298 (164% 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 |
|---|---|---|
| Paired Kidney Exchange | $45 - $102 | 25% |
| UnitedHealthcare | $52 - $999 | 29% |
| Horizon Nj Health | $58 - $138 | 32% |
| Health Partners | $69 - $783 | 38% |
| Keystone Mercy Health Plan | $69 - $783 | 38% |
| Preferred Health Care Eliance | $76 - $172 | 42% |
| Aetna | $78 - $783 | 43% |
| Pgm - Regie De L'Assurance Maladie Quebec | $79 - $180 | 44% |
| Upmc | $86 - $783 | 47% |
| Blue Cross Blue Shield | $93 - $594 | 51% |
| Gspp And Wissahickon Hospice | $93 | 51% |
| Cigna | $119 - $352 | 66% |
| Pgm - Kuwait Defense | $120 - $352 | 66% |
| Qualcare | $131 - $298 | 72% |
| Medicaid / KanCare | $132 - $783 | 73% |
| Olympus | $135 - $308 | 74% |
| Coventry | $138 - $399 | 76% |
| Pgm - Chop | $138 - $313 | 76% |
| Wissahickon Hospice | $138 - $313 | 76% |
| Healthamerica/Coventry | $155 - $384 | 85% |
| First Health Global | $172 - $392 | 95% |
| Kaiser Permanente | $187 - $783 | 103% |
| Medicare (plans) | $187 - $190 | 103% |
| Philadelphia Va Medical Center | $187 | 103% |
| Tricare | $187 | 103% |
| Geisinger Health Plan | $192 - $592 | 106% |
| Humana | $192 - $626 | 106% |
| Devoted Health | $196 | 108% |
| Pa Health And Wellness | $196 - $308 | 108% |
| Penn Life (Living Independently For Elders) | $196 | 108% |
| Clover Health Plan | $201 | 111% |
| Health Net | $206 - $470 | 114% |
| Pgm - Royal Embassy Of Saudi Arabia | $206 - $470 | 114% |
| Keystone First | $207 | 114% |
| Us Family Health Plan | $215 | 119% |
| Pgm - Embassy Of Qatar | $224 - $509 | 124% |
| Pgm - Ontario Ministry Of Health And Long-Term Care (Ohip) | $224 - $509 | 124% |
| Interlink | $230 - $525 | 127% |
| Gateway Health Plan | $231 | 127% |
| Pgm - Embassy Of The United Emirates/Ipc | $241 - $548 | 133% |
| Elap | $265 | 146% |
| Health America/Ccn | $275 - $626 | 152% |
| Intergroup | $275 - $626 | 152% |
| Pgm - Kuwait Health Division | $275 - $626 | 152% |
| Pgm - Kuwait Oil | $275 - $626 | 152% |
| Preferred Care | $275 - $626 | 152% |
| Claims Watcher | $298 - $336 | 164% |
| Oscar Health Plan | $317 | 175% |
| Centivo | $336 | 185% |
| Blue Quality Centers For Transplant (Bqct) | $344 - $783 | 190% |
| City Of Philadelphia Behavioral Health | $344 - $783 | 190% |
| Commercial Other | $344 - $783 | 190% |
| International Pfs | $344 - $783 | 190% |
| Pa Medical Assistance | $344 - $783 | 190% |
| United Behavioral Health | $344 - $783 | 190% |
| Workers Compensation | $344 - $783 | 190% |
| Elap Services | $347 | 191% |
| Highmark | $392 | 216% |
| Penn Global Medicine | $494 | 272% |
| Ibc | $594 | 328% |
| Ibc Commercial Hpn | $594 | 328% |
| Keystone Hmo Proactive | $594 | 328% |