CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Atrium Health Navicent the Medical Center

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90791
Insurance Median: $144
Cash Discount Price: $77
vs. Medicare Baseline: 0.79x Medicare

The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Atrium Health Navicent the Medical Center is $144. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $77. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 0.79x the Medicare baseline. Located in 777 Hemlock Street, Macon, GA.

Cash / Self-Pay

$77

Average discount available for prompt cash payment at this facility.

Insurance Median

$144

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: $77 (42%)

Insurance Median: $144 (79%)

Cash: $77 (42% of Medicare)

Ins. Median: $144 (79% 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.

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
Ambetter / Centene	$46 - $191	25%
Securehealth	$54 - $224	30%
Aetna	$90 - $157	50%
Humana	$90 - $157	50%
Kaiser	$99 - $146	55%
Multiplan	$99 - $214	55%
Cigna	$101 - $156	56%
Ibg	$108 - $214	60%
Novanet	$122 - $214	67%
Three Rivers Provider Network	$130 - $228	72%
Beechstreet	$142 - $214	78%
Blue Cross Blue Shield	$142 - $489	78%
Georgia Health Advantage	$142 - $157	78%
UnitedHealthcare	$142 - $1,910	78%
Care Source	$144 - $160	79%
Clover	$144 - $160	79%
Eon Health	$144 - $160	79%
Pruitt Health	$149 - $157	82%
Alliant	$170 - $358	94%

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 $77.
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 Atrium Health Navicent the Medical Center 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.