CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Mercy Health Lakeshore Campus

Billing Code: 90791 (CPT)

The BaseRate · fair price high confidence
A fair price for this
$120
about 0.7× the $181 Medicare rate · typically $120–$178
modeled estimate · not a bill or quote
What this hospital charges insurers
$205
Above the fair price
about $85 over the fair price · 1.1× Medicare
Medicare pays $181 Fair price $120 This hospital $205 Hospital's list price $352

How we calculate the fair BaseRate →

How this hospital compares to other MI hospitals

Highest price of the 9 MI hospitals we have prices for — worth calling around.

Cheapest $109 Priciest $205

Black dot = this hospital, among the 9 MI hospitals with a price for this procedure. Full list below.

A fair price for a Psychiatric evaluation (first visit) is about $120 (about 0.7× the $181 Medicare rate). Mercy Health Lakeshore Campus charges insurers about $205 — above the fair price. Located in Shelby, MI.

This price is above the fair BaseRate — you may be able to pay less

Ask the hospital for the cash / self-pay price, check whether you qualify for financial assistance, or negotiate the bill down toward the fair price of about $120. Many patients pay well below the first number they’re quoted — the checklists below walk you through it.

What each insurance company pays

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

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

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser 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 $159 - $175 88%
Blue Cross Blue Shieldmajor $170 - $217 94%
Aetnamajor $125 - $288 69%
Cignamajor $170 - $206 94%
Humanamajor $170 - $211 94%
Ambetter (Centene) $170 94%
AmeriHealth $197 - $211 109%
Dean Health Plan $172 - $229 95%
GEHA $159 88%
Health Net $170 - $253 94%
HealthPartners $157 - $170 87%
MagnaCare $197 - $211 109%
Medical Mutual $197 - $211 109%
Meridian $170 94%
Molina $170 - $229 94%
MVP Health Care $172 - $229 95%
Oscar Health $172 - $229 95%
Paramount $170 94%
Presbyterian $170 94%
Priority Health $186 - $219 103%
Tufts Health Plan $157 - $170 87%
UniCare $197 - $211 109%
WellSense $170 94%
+ 350 smaller / regional plans $121 - $364
Government programs also on file: Medicare, Medicaid, Military & VA.
Excludes 16 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Insurance Before you use insurance

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

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Facility Profile & Credentials

  • Address: 72 South State Street, Shelby, MI 49455
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals