CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Texas Scottish Rite Hospital for Children

Billing Code: 90791 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$162

about 0.9× the $181 Medicare rate · typically $130–$291

modeled estimate · not a bill or quote

What this hospital charges insurers

$385

Well above the fair price

about $223 over the fair price · 2.1× Medicare

Medicare pays $181 Fair price $162 This hospital $385 Cash price $385 Hospital's list price $385

How we calculate the fair BaseRate →

How this hospital compares to other TX hospitals

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

Cheapest $76 Priciest $385

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

A fair price for a Psychiatric evaluation (first visit) is about $162 (about 0.9× the $181 Medicare rate). Texas Scottish Rite Hospital for Children charges insurers about $385, or about $385 in cash — well above the fair price. Located in Dallas, TX.

This price is above the fair BaseRate — you may be able to pay less

Ask the hospital for the cash / self-pay price, check whether you qualify for financial assistance, or negotiate the bill down toward the fair price of about $162. Many patients pay well below the first number they’re quoted — the checklists below walk you through it.

What each insurance company pays

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

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

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna HumanaKaiser 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	$289 - $385	159%
Blue Cross Blue Shieldmajor	$130 - $385	72%
Aetnamajor	$236 - $385	130%
Cignamajor	$212	117%
Molina	$385	212%
+ 8 smaller / regional plans	$270 - $404

Government programs also on file: Medicaid, Military & VA.

Excludes 1 rental-network / third-party entry (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 385), 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 Texas Scottish Rite Hospital for Children 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 Texas Scottish Rite Hospital for Children

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

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