CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Baylor Scott & White Medical Center Pflugerville

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90791
Insurance Median: $260
Cash Discount Price: $317
vs. Medicare Baseline: 1.43x Medicare

The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Baylor Scott & White Medical Center Pflugerville is $260. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $317. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.43x the Medicare baseline. Located in 2600 East Pflugerville Parkway, Pflugerville, TX.

Cash / Self-Pay

$317

Average discount available for prompt cash payment at this facility.

Insurance Median

$260

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: $317 (175%)

Insurance Median: $260 (143%)

Cash: $317 (175% of Medicare)

Ins. Median: $260 (143% 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
Superior Health Plan	$95 - $143	52%
Humana	$113 - $370	62%
Baylor Scott & White Health Plan	$135 - $235	74%
Triwest	$143	79%
Corvel	$149	82%
Prime Health Services	$149	82%
American Health Plan	$150	83%
Healthspring	$150	83%
Procare Advantage	$150	83%
UnitedHealthcare	$164 - $365	90%
Sedgwick	$213	117%
Blue Cross Blue Shield	$243 - $296	134%
Cigna	$251 - $293	138%
Aetna	$290	160%
Midcoast	$290	160%
Quiktrip	$290	160%
University Of Mary Hardin-Baylor	$306	169%
Independent Medical System	$317	175%
Curative	$343	189%
First Health	$370	204%
Healthsmart	$370 - $396	204%
Private Health Care System	$396	218%
Three Rivers	$475	262%

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 $317.
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 Baylor Scott & White Medical Center Pflugerville 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.