CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Medical City Plano

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90791
  • Insurance Median: $184
  • Cash Discount Price: $537
  • vs. Medicare Baseline: 1.01x Medicare
The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Medical City Plano is $184. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $537. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.01x the Medicare baseline. Located in 3901 W 15Th St, Plano, TX.
Cash / Self-Pay
$537

Average discount available for prompt cash payment at this facility.

Insurance Median
$184

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: $537 (296%)
Insurance Median: $184 (101%)
Cash: $537 (296% of Medicare)
Ins. Median: $184 (101% 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
Superior Health Plan $35 - $40 19%
Humana $56 31%
Cigna $67 - $215 37%
Aetna $81 - $349 45%
United $87 - $101 48%
Oscar $103 - $120 57%
Healthcare Highways $122 - $195 67%
Blue Cross Blue Shield $123 - $256 68%
Evry Health $128 - $149 71%
Lifecare Hospitals $149 - $173 82%
Curative Administrators $199 - $231 110%
Prominence Health Plan $199 - $231 110%
City Of Mckinney $224 - $260 124%
Fidelis Securecare $224 - $260 124%
National Choicecare $249 - $289 137%
Pc Texas Partners $274 - $318 151%
Physicians Coop Of Tx $274 - $318 151%
Rockport Health Group $274 - $318 151%
Averde Health, Inc $288 - $335 159%
Texas Healthcare Foundation Wc $323 - $375 178%
Coastal Comp Health Networks $348 - $404 192%
Mega Life $348 - $404 192%
Multiplan Phcs $348 - $404 192%
Healthsmart Preferred Care $373 - $433 206%
Lewisville Isd/Dls Consulting $373 - $433 206%
Usa Managed Care $398 - $462 219%
Usc Health Services $398 - $462 219%
Galaxy Health Network $423 - $491 233%
Independent Medical Systems $497 - $578 274%
National Healthcare Solutions $497 - $578 274%
Unicare $497 - $578 274%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3901 W 15Th St, Plano, TX 75075
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals