CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Mayers Memorial Hospital

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90791
Insurance Median: $384
Cash Discount Price: $404
vs. Medicare Baseline: 2.12x Medicare

The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Mayers Memorial Hospital is $384. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $404. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 2.12x the Medicare baseline. Located in 43563 Hwy 299 East, Fall River Mills, CA.

Cash / Self-Pay

$404

Average discount available for prompt cash payment at this facility.

Insurance Median

$384

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: $404 (223%)

Insurance Median: $384 (212%)

Cash: $404 (223% of Medicare)

Ins. Median: $384 (212% 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 212% of the Medicare baseline (a markup of 112%). 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
Medi-Cal	$184	101%
Blue Cross Blue Shield	$311 - $345	172%
Blue Shield Ca Va	$313	173%
Blue Shield Mcr Adv	$313	173%
Arcadian Health Services-All Plans	$329	181%
Health Net Mcr Adv	$329	181%
Tricare	$329	181%
Blue Shield Ca Exchange	$345	190%
Health Net Prison	$359	198%
Imperial Health Plan-All Plans	$372	205%
Blue Shield-All Other Plans	$384	212%
Cigna	$384	212%
Corvel Ppo-All Plans	$384	212%
Coventry/First Health-All Plans	$384	212%
Hmn-All Plans	$384	212%
Integrated Hp-All Plans	$384	212%
Interplan-All Plans	$384	212%
Multiplan Phcs-All Plans	$384	212%
Pfmc-All Plans	$384	212%
Superior Ca-All Plans	$384	212%
Health Net-All Other Plans	$402	222%
Pacificare-All Plans	$404	223%
Partnership Hp-All Plans	$404	223%

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 $404.
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 Mayers Memorial Hospital 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.