CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: North Adams Regional Hospital Corporation

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90791
  • Insurance Median: $247
  • Cash Discount Price: $363
  • vs. Medicare Baseline: 1.36x Medicare
The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at North Adams Regional Hospital Corporation is $247. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $363. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.36x the Medicare baseline. Located in 71 Hospital Avenue, North Adams, MA.
Cash / Self-Pay
$363

Average discount available for prompt cash payment at this facility.

Insurance Median
$247

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: $363 (200%)
Insurance Median: $247 (136%)
Cash: $363 (200% of Medicare)
Ins. Median: $247 (136% 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.

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
Medicaid / KanCare $88 - $168 49%
Tricare $144 - $171 79%
Blue Cross Blue Shield $154 - $325 85%
Medicare (plans) $154 - $187 85%
Mcrmanaged Cca One Care $155 - $201 85%
Comm Hospice $156 - $178 86%
Mcr Miscellaneous $156 - $178 86%
Mcrmanaged Usa Family $156 - $178 86%
Mcrmanaged Va $156 - $178 86%
Oth United Vaccn $178 98%
Aetna $197 - $289 109%
Comm Fallon Qhp $216 - $218 119%
Comm Network Qhpsub $216 - $231 119%
Mcdmanaged Network $216 - $233 119%
Wc Workers Comp $232 128%
Comm Network Qhpnonsub $245 - $275 135%
Comm Nhp $247 136%
Comm Unicare $248 - $260 137%
Comm Hne Hmo $264 - $321 146%
Comm Hne $279 - $341 154%
Comm Hne Ppo $280 - $341 154%
Comm Tufts $303 167%
UnitedHealthcare $329 181%
Cigna $344 - $356 190%
Comm Cdphp $344 190%
Comm Mvp $344 190%
Comm Oxford $344 190%
Comm First Health $356 - $363 196%
Comm Connecticare $363 200%
Comm Consolidated Health $363 200%
Comm Harvard $363 200%
Comm Other $363 200%
Comm Phcs $363 200%
Comm Self Pay $363 200%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 71 Hospital Avenue, North Adams, MA 01247
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Federal
  • Hospital Type: Critical Access Hospitals