CMS Price Transparency Data
Psychiatric evaluation (first visit)
Facility: Seattle Children's Hospital
Billing Code: 90791 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 90791
- Insurance Median: $455
- Cash Discount Price: $606
- vs. Medicare Baseline: 2.51x Medicare
The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Seattle Children's Hospital is $455. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $606. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 2.51x the Medicare baseline. Located in 4800 Sand Point Way Ne, Po Box C-5371, Seattle, WA.
Cash / Self-Pay
$606
Average discount available for prompt cash payment at this facility.
Insurance Median
$455
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: $606 (334%)
Insurance Median: $455 (251%)
Cash: $606 (334% of Medicare)
Ins. Median: $455 (251% 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 251% of the Medicare baseline (a markup of 151%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Child Hearing League [17301] | $104 | 57% |
| Hospice [17306] | $104 | 57% |
| Maple Lane School [17309] | $104 | 57% |
| Medicaid / KanCare | $104 | 57% |
| Chpw [15802] | $107 | 59% |
| Coordinated Care [15815] | $109 | 60% |
| Icw Wellpoint [15822] | $109 | 60% |
| Kaiser [15818] | $109 | 60% |
| Molina [15809] | $109 | 60% |
| Opticare [15895] | $109 | 60% |
| Wellpoint [15814] | $109 | 60% |
| Ubh Community & State [15819] | $114 | 63% |
| UnitedHealthcare | $114 - $515 | 63% |
| Eye Quest [15894] | $119 | 66% |
| Usfhp [12208] | $174 - $248 | 96% |
| Cigna | $184 - $515 | 101% |
| Coordinated Care [12267] | $233 - $454 | 128% |
| Asuris [11900] | $242 - $503 | 133% |
| Asuris [11913] | $242 - $327 | 133% |
| Bridgespan Health Company [11906] | $242 - $327 | 133% |
| Chpw Cascade [12228] | $242 - $333 | 133% |
| Pb Regence [11908] | $242 | 133% |
| Regence Ump [12263] | $242 - $394 | 133% |
| Regence [11903] | $242 - $503 | 133% |
| Regence [11909] | $242 - $327 | 133% |
| Molina Marketplace [12831] | $243 - $454 | 134% |
| Aetna | $266 - $509 | 147% |
| Ameriben [11006] | $266 - $509 | 147% |
| Christian Brothers [11001] | $266 - $509 | 147% |
| Coresource [11004] | $266 - $509 | 147% |
| Ebms [11003] | $266 - $509 | 147% |
| Meritain [12251] | $266 - $576 | 147% |
| Moda [11009] | $266 - $509 | 147% |
| Preferred One [11008] | $266 - $509 | 147% |
| Web Tpa [11007] | $266 - $509 | 147% |
| Pb Premera [11601] | $288 | 159% |
| Premera [11600] | $288 - $503 | 159% |
| Administrators [13102] | $312 - $515 | 172% |
| Allied [13129] | $312 - $515 | 172% |
| Assurant Health Fc [13135] | $312 - $515 | 172% |
| Coastal Administrative [13140] | $312 - $515 | 172% |
| Ebms Fc [13144] | $312 - $515 | 172% |
| First Choice [13399] | $312 - $515 | 172% |
| Health Alliance [13233] | $312 - $515 | 172% |
| Ilwu-Pma [13158] | $312 - $515 | 172% |
| Loomis Benefits West [13161] | $312 - $515 | 172% |
| Meritain Health [13229] | $312 - $515 | 172% |
| Moda Fc [13219] | $312 - $515 | 172% |
| Myers Stevens & Toohey [13169] | $312 - $515 | 172% |
| Pacific Underwriters [13175] | $312 - $515 | 172% |
| Personify Fc [13155] | $312 - $515 | 172% |
| Providence Health Plan [13181] | $312 - $515 | 172% |
| Rehn & Associates [13182] | $312 - $515 | 172% |
| Samaritan Health [12265] | $312 | 172% |
| Starmark [13103] | $312 - $515 | 172% |
| Tongass Timber Trust [13202] | $312 - $515 | 172% |
| Trusteed Plans [13186] | $312 - $515 | 172% |
| Trustmark Life Insurance [13203] | $312 - $515 | 172% |
| Welfare Pension [13120] | $312 - $515 | 172% |
| Wship [13121] | $312 - $515 | 172% |
| Zenith American Solutions [13195] | $312 - $515 | 172% |
| Kaiser [13400] | $333 - $454 | 184% |
| Kaiser [13401] | $348 - $394 | 192% |
| Allegiance [12264] | $365 - $515 | 201% |
| Personify [12270] | $365 - $515 | 201% |
| Providence Health Plan [12289] | $365 - $515 | 201% |
| Tufts Health Plan [12279] | $365 - $515 | 201% |
| United Behavioral Health [12234] | $380 - $533 | 210% |
| Claritev [12299] | $485 - $576 | 267% |
| Ebms [12241] | $485 - $576 | 267% |
| Health Alliance [12266] | $485 - $576 | 267% |
| Humana | $485 - $576 | 267% |
| Key Benefit Admin [12276] | $485 - $576 | 267% |
| Medical Mutual [12233] | $485 - $576 | 267% |
| Moda [12842] | $485 - $576 | 267% |
| Nippon Life Insurance [12232] | $485 - $576 | 267% |
| Pehp [12235] | $485 - $576 | 267% |
| Preferredone Admin Services [12236] | $485 - $576 | 267% |
| Select Health [12277] | $485 - $576 | 267% |
| Blue Cross Blue Shield | $503 | 277% |
| Carpenters Trust [13100] | $515 | 284% |
| Coventry Fc [13112] | $515 | 284% |
| Guardian Fc [13105] | $515 | 284% |
| Kps [13109] | $515 | 284% |
| Mega Life [13111] | $515 | 284% |
| Principal Mutual Fc [13115] | $515 | 284% |
| Psew [13124] | $515 | 284% |
| Sound Health And Wellness [13116] | $515 | 284% |
| Zenith [13123] | $515 | 284% |
| Coastal Admin Svcs Contracted [12222] | $545 | 301% |
| Personify Contracted [12205] | $545 | 301% |
| Altius Health Plan [12275] | $582 | 321% |
| Coventry Mhbp [12272] | $582 | 321% |
| Coventry [12244] | $582 | 321% |
| First Health [12210] | $582 | 321% |
| Hcc Medical [12274] | $582 | 321% |
| Lewermark [12286] | $582 | 321% |
| Medishare [12287] | $582 | 321% |
| Pacificsource [12245] | $582 | 321% |
| Rural Carrier Benefit Plan [12271] | $582 | 321% |