CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: St Jude Childrens Research Hospital

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90791
Insurance Median: $293
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.62x Medicare

The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at St Jude Childrens Research Hospital is $293. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.62x the Medicare baseline. Located in 262 Danny Thomas Place, Memphis, TN.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$293

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%)

Insurance Median: $293 (162%)

Ins. Median: $293 (162% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Healthcare Connections La	$69	38%
UnitedHealthcare	$69 - $324	38%
Healthy Blue	$112	62%
Medicaid / KanCare	$119	66%
Home State Health	$130	72%
Molina Marketplace Of Ms	$172	95%
Health Choice - Ok	$270	149%
Vantage	$270 - $302	149%
Humana	$292	161%
Tricare	$315	174%
Aetna	$338	186%
Private Health Care Systems	$360	199%
Ms Physicians Care Network	$382	211%
Baptist Health	$405	223%
Cigna	$405	223%
First Health Ccn	$405	223%
Health Choice	$405	223%
Health Link Mississippi	$405	223%
Healthscope Benefits Inc	$405	223%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $X.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 90791.

Insurance In-Network Protection Plan

Contact your insurance company to confirm St Jude Childrens Research Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 90791.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.