CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Harlingen Medical Center

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90791
  • Insurance Median: $177
  • Cash Discount Price: $177
  • vs. Medicare Baseline: 0.98x Medicare
The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Harlingen Medical Center is $177. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $177. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 0.98x the Medicare baseline. Located in 5501 South Expressway 77, Harlingen, TX.
Cash / Self-Pay
$177

Average discount available for prompt cash payment at this facility.

Insurance Median
$177

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: $177 (98%)
Insurance Median: $177 (98%)
Cash: $177 (98% of Medicare)
Ins. Median: $177 (98% 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
Aetna $177 98%
Blue Cross Blue Shield $177 98%
Careworks Worker Compensation Fka Rockport Community Network $177 98%
Cigna $177 - $183 98%
Humana $177 98%
Medicare (plans) $177 98%
San Benito Medical Associates $177 98%
Superior Health Plan $177 98%
Texas Bluebonnett Health Plan $177 - $293 98%
Tricare $177 98%
UnitedHealthcare $177 98%
Veterans Evaluation Services $177 98%
Wellmed $177 98%
Workers Compensation $177 98%
Molina $186 - $275 103%
Provider Partners Health Plan $186 103%
Imperial Insurance Company $188 104%
Asserta Health $231 127%
Friday Health Plan $231 127%
Magic Valley Electric Cooperative $231 127%
Superior Health Commercial Exchange $231 127%
Employer Direct Healthcare $248 137%
Corporate Remedies Worker Compensation $266 147%
Naphcare $275 152%
Baker Benefits Administrators $355 196%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 5501 South Expressway 77, Harlingen, TX 78550
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals