CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Holland Community Hospital

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90791
Insurance Median: $139
Cash Discount Price: $123
vs. Medicare Baseline: 0.77x Medicare

The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Holland Community Hospital is $139. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $123. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 0.77x the Medicare baseline. Located in 602 Michigan Ave, Holland, MI.

Cash / Self-Pay

$123

Average discount available for prompt cash payment at this facility.

Insurance Median

$139

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: $123 (68%)

Insurance Median: $139 (77%)

Cash: $123 (68% of Medicare)

Ins. Median: $139 (77% 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
Molina Mcaid - All Plans	$24 - $110	13%
Ph Mcaid	$24 - $110	13%
Nomi Health - All Plans	$42 - $125	23%
UnitedHealthcare	$50 - $137	28%
Aetna	$53 - $261	29%
Cofinity -All Plans	$53 - $261	29%
Multiplan - All Plans	$66 - $260	36%
Benefit Source Inc-All Plans	$68 - $236	37%
First Health-All Plans	$68 - $204	37%
Usa Managed Care-All Plans	$68 - $204	37%
Integrated Health Plans-All Plans	$72 - $216	40%
Meridian Mcaid Profee Only-All Plans	$110	61%
Lifesynch Bh Comm - All Other Plans	$120	66%
Lifesynch Bh Mcr	$120	66%
Life Circles-All Plans	$130 - $168	72%
Health Alliance Mcr Adv	$137 - $177	76%
Ph Mcr Adv	$137 - $177	76%
Va Ccn - All Plans	$137 - $177	76%
Longevity Health Plan-All Plans	$148 - $191	82%
Cigna	$160 - $218	88%
Sisco Epi	$164	90%
Sisco-All Other Plans	$164 - $200	90%
Blue Cross Blue Shield	$186	103%
Priority Health - All Other Plans	$195 - $241	108%
Blue Care Network - All Plans	$203 - $225	112%
Asr - All Plans	$217 - $419	120%
Health Alliance Ahl - All Other Plans	$217 - $419	120%
Health Alliance Hmo	$217 - $401	120%
United Behav Hlth Mcr	$264	146%
United Behav Hlth - All Other Plans	$301	166%

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 $123.
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 Holland Community 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.