CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Northside Hospital Forsyth

Billing Code: 90791 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$248

about 1.4× the $181 Medicare rate · typically $166–$322

modeled estimate · not a bill or quote

What this hospital charges insurers

$204

Below the fair price — a good deal

about $44 under the fair price · 1.1× Medicare

Medicare pays $181 Fair price $248 This hospital $204 Cash price $487 Hospital's list price $649

How we calculate the fair BaseRate →

How this hospital compares to other GA hospitals

Highest price of the 9 GA hospitals we have prices for — worth calling around.

Cheapest $101 Priciest $204

Black dot = this hospital, among the 9 GA hospitals with a price for this procedure. Full list below.

A fair price for a Psychiatric evaluation (first visit) is about $248 (about 1.4× the $181 Medicare rate). Northside Hospital Forsyth charges insurers about $204, or about $487 in cash — below the fair price — a good deal. Located in Cumming, GA.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

6 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana✓ Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$177	98%
Blue Cross Blue Shieldmajor	$177 - $452	98%
Aetnamajor	$181 - $441	100%
Cignamajor	$93 - $409	51%
Humanamajor	$179 - $184	99%
Kaiser Permanentemajor	$183 - $565	101%
Ambetter (Centene)	$78 - $305	43%
Amerigroup	$92 - $133	51%
CareSource	$81 - $241	45%
Clover Health	$186	103%
Health Net	$402	222%
Oscar Health	$305	168%
WellCare	$183	101%
+ 23 smaller / regional plans	$108 - $649

Government programs also on file: Medicare, Medicaid, Military & VA.

Excludes 9 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 487), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 90791.

Insurance Before you use insurance

Call your insurance company to confirm Northside Hospital Forsyth is in-network.
Ask your insurer whether prior approval is required for CPT code 90791.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Northside Hospital Forsyth

Compare: Psychiatric evaluation (first visit) at other GA hospitals

Insurance negotiated median for the same procedure, sorted lowest first.