CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Lowell General Hospital

Billing Code: 90791 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$197

about 1.1× the $181 Medicare rate · typically $134–$276

modeled estimate · not a bill or quote

Medicare pays $181 Fair price $197 Cash price $269 Hospital's list price $384

How we calculate the fair BaseRate →

What each insurance company pays

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

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

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna HumanaKaiser 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	$200 - $315	110%
Blue Cross Blue Shieldmajor	$213 - $320	117%
Aetnamajor	$303 - $353	167%
Cignamajor	$32 - $192	18%
AmeriHealth	$134	74%
AvMed	$134	74%
GEHA	$134	74%
Harvard Pilgrim	$200	110%
Tufts Health Plan	$27 - $218	15%
WellSense	$134	74%
+ 102 smaller / regional plans	$134 - $320

Government programs also on file: Medicare, Medicaid.

Excludes 12 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 269), 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 Lowell General Hospital 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 Lowell General Hospital

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

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