CMS Price Transparency Data
Psychiatric evaluation (first visit)
Facility: Clovis Community Medical Center
Billing Code: 90791 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 90791
- Insurance Median: $206
- Cash Discount Price: $430
- vs. Medicare Baseline: 1.14x Medicare
The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Clovis Community Medical Center is $206. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $430. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.14x the Medicare baseline. Located in 2755 Herndon Ave, Clovis, CA.
Cash / Self-Pay
$430
Average discount available for prompt cash payment at this facility.
Insurance Median
$206
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: $430 (237%)
Insurance Median: $206 (114%)
Cash: $430 (237% of Medicare)
Ins. Median: $206 (114% 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.
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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 |
|---|---|---|
| Blue Shield | $129 - $306 | 71% |
| Central Valley Medical Providers | $134 - $376 | 74% |
| Community Care | $137 | 76% |
| Generic Ccs Other Counties | $163 | 90% |
| Medi-Cal California Health & Wellness Plan | $163 | 90% |
| Medi-Cal Community Health Group | $163 | 90% |
| Ccs Fresno | $163 | 90% |
| Medi-Cal Molina | $163 | 90% |
| Medi-Cal Health Plan of San Mateo | $163 | 90% |
| San Francisco Health Plan Medi-Cal | $163 | 90% |
| Ccs Stanislaus | $163 | 90% |
| Medi-Cal Contra Costa Health Plan | $163 | 90% |
| Medi-Cal Cencal Health | $163 | 90% |
| Gold Coast Medi-Cal | $163 | 90% |
| Medi-Cal Alameda Alliance for Health | $163 | 90% |
| Ccs Kings | $163 | 90% |
| Medi-Cal Kern Family Health | $163 | 90% |
| Ccs Tulare | $163 | 90% |
| Medi-Cal Inland Empire Health | $163 | 90% |
| Ccs Madera/Sacramento | $163 | 90% |
| Ccs Merced | $163 | 90% |
| Medi-Cal La Care Health | $163 | 90% |
| Santa Clara Family Health Plan - Premier Health | $163 | 90% |
| Ccs Kern | $163 | 90% |
| Santa Clara Family Health Plan - Valley Health | $163 | 90% |
| Fresno County Funded Specialty Care | $163 | 90% |
| Genetically Handicapped Person | $163 | 90% |
| Cal Caloptima | $163 | 90% |
| Chdp | $163 | 90% |
| Ccs Mariposa | $163 | 90% |
| Blue Cross Blue Shield | $163 - $341 | 90% |
| Medi-Cal Blue Shield Promise Health | $163 | 90% |
| Medi-Cal Partnership Health Plan of Ca | $163 | 90% |
| Generic Care Out of County | $163 | 90% |
| Sante-Blue Shield/Sante | $179 - $228 | 99% |
| Healthnet HMO - Sante | $179 - $228 | 99% |
| Bscphp - Dhmso | $179 - $228 | 99% |
| Blue Shield Saint Agnes | $179 - $228 | 99% |
| Humana | $179 - $456 | 99% |
| Advantek Table Mountain Rancheria Tribal Member | $179 - $228 | 99% |
| UnitedHealthcare | $179 - $282 | 99% |
| Todays Pyramid | $179 - $228 | 99% |
| Hartford Life Supplement | $179 - $228 | 99% |
| Railroad Part B | $179 - $228 | 99% |
| Cigna | $179 - $333 | 99% |
| Medi-Cal Innovative Integrated Health | $179 - $228 | 99% |
| Blue Shield Hmo-Cvmp/Medpro | $179 - $228 | 99% |
| Meritage Healthnet HMO | $179 - $228 | 99% |
| Blue Shield Sante | $179 - $228 | 99% |
| Generic Bscphp | $179 - $228 | 99% |
| Cares Act Provider Relief Fund | $179 - $228 | 99% |
| Healthnet Sante | $179 - $228 | 99% |
| Generic Victims of Crime | $179 - $228 | 99% |
| Blue Shield 65 Plus HMO Ehs | $179 - $228 | 99% |
| Railroad Part A | $179 - $228 | 99% |
| Care1St HMO - Ehs | $179 - $228 | 99% |
| Sequoia Pace - Peak Tpa | $179 - $228 | 99% |
| Victims of Crime | $179 - $228 | 99% |
| Well Path (Cfmg) | $179 - $591 | 99% |
| Wellcare | $179 - $228 | 99% |
| Generic | $179 - $228 | 99% |
| Healthnet HMO - La Salle | $179 - $228 | 99% |
| Meritage Blue Shield 65 Plus | $179 - $228 | 99% |
| Sante-Sub Cap Ma Brand New Day | $179 - $228 | 99% |
| Healthnet HMO - Cvmp/Medpro | $179 - $228 | 99% |
| Gemcare HMO | $179 - $228 | 99% |
| Bscphp HMO - First Choice | $179 - $228 | 99% |
| Healthnet Sante Dual Risk | $179 - $228 | 99% |
| Healthnet HMO - Dhmso | $179 - $228 | 99% |
| Aetna | $179 - $718 | 99% |
| Sante Sub Cap Healthnet Seniority | $179 - $228 | 99% |
| Blue Shield Promise - Imperial | $179 - $228 | 99% |
| Meritage Brand New Day | $179 - $228 | 99% |
| Bscphp - First Choice | $179 - $228 | 99% |
| Us Marshal | $179 - $228 | 99% |
| Scan Health Plan | $179 - $228 | 99% |
| Medicare (plans) | $179 - $228 | 99% |
| Sante Sub Cap-Blue Shield/Sante | $179 - $228 | 99% |
| Blue Shield 65 Plus HMO First Choice | $179 - $228 | 99% |
| Brand New Day | $179 - $228 | 99% |
| Sante-Healthnet Seniority | $179 - $228 | 99% |
| Sante | $179 - $253 | 99% |
| Healthnet Sante - Sub Cap Dual Risk | $179 - $228 | 99% |
| Railroad Part A & B | $179 - $228 | 99% |
| Kaiser | $181 | 100% |
| Alignment Health Plan | $197 - $251 | 109% |
| Innovative Integrated Health Community Plans HMO | $197 - $251 | 109% |
| Champion Health Plan of California Ma | $197 - $251 | 109% |
| Imperial Health Plan HMO | $206 - $263 | 114% |
| Employer 90/40 | $215 | 119% |
| Correctcare Integrated Health | $233 - $297 | 128% |
| Sequoia Pace | $245 | 135% |
| Health Plan of San Joaquin | $245 | 135% |
| Adventist -McL Calviva Sub Cap | $269 | 148% |
| Central Ca Indian Health | $295 | 163% |
| Nx Health Network PPO | $295 | 163% |
| Healthnet | $314 - $315 | 173% |
| Coalinga State Hospital | $359 - $457 | 198% |
| Healthsmart | $365 - $430 | 201% |
| Naphcare Inc-Mendota | $386 - $491 | 213% |
| Network By Design | $403 | 222% |
| Coventry Health Care (First Health Network) | $403 | 222% |
| PHCS | $456 | 251% |
| Generic Multiplan | $456 | 251% |