CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: McLaren Lapeer Region

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90791
Insurance Median: $144
Cash Discount Price: $151
vs. Medicare Baseline: 0.79x Medicare

The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at McLaren Lapeer Region is $144. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $151. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 0.79x the Medicare baseline. Located in 1375 N Main St, Lapeer, MI.

Cash / Self-Pay

$151

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: $151 (83%)

Insurance Median: $144 (79%)

Cash: $151 (83% 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
Medicaid / KanCare	$88 - $123	49%
Mclaren Commercial Ins	$125	69%
Humana	$137 - $157	76%
Medicare (plans)	$137 - $251	76%
Hap - Hmo	$147	81%
UnitedHealthcare	$148	82%
Tricare	$150	83%
Mi Amish Medical Board	$157	87%
U Of M Health Plan	$157	87%
Aetna	$175	97%
Priority Health	$176	97%
Blue Cross Blue Shield	$186	103%

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 $151.
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 McLaren Lapeer Region 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.