CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Holy Cross Hospital-Jordan Valley

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90791
Insurance Median: $395
Cash Discount Price: $311
vs. Medicare Baseline: 2.18x Medicare

The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Holy Cross Hospital-Jordan Valley is $395. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $311. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 2.18x the Medicare baseline. Located in 3580 West 9000 South, West Jordan, UT.

Cash / Self-Pay

$311

Average discount available for prompt cash payment at this facility.

Insurance Median

$395

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: $311 (172%)

Insurance Median: $395 (218%)

Cash: $311 (172% of Medicare)

Ins. Median: $395 (218% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 218% of the Medicare baseline (a markup of 118%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Aetna	$120 - $656	66%
Colorado Access	$120	66%
Denver Health	$120	66%
Health Choice	$120	66%
Molina	$120 - $333	66%
Rocky Mountain Health Plan	$120	66%
Uuhp	$120 - $421	66%
Humana	$139	77%
Medicare (plans)	$139	77%
Employer Direct Healthcare	$174	96%
Blue Cross Blue Shield	$180 - $466	99%
Motivhealth	$184	101%
Cigna	$278 - $621	153%
Pehp	$332 - $776	183%
Deseret Mutual Benefit Administrators	$370 - $477	204%
Centura Employee Plan	$388	214%
Wise	$404 - $412	223%
Select Health	$514	283%
Multiplan	$536 - $707	296%
Emi Health	$776	428%
UnitedHealthcare	$776	428%

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 $311.
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 Holy Cross Hospital-Jordan Valley 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.