CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Charlevoix Area Hospital

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90791
Insurance Median: $241
Cash Discount Price: $303
vs. Medicare Baseline: 1.33x Medicare

The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Charlevoix Area Hospital is $241. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $303. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.33x the Medicare baseline. Located in 14700 Lakeshore Drive, Charlevoix, MI.

Cash / Self-Pay

$303

Average discount available for prompt cash payment at this facility.

Insurance Median

$241

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: $303 (167%)

Insurance Median: $241 (133%)

Cash: $303 (167% of Medicare)

Ins. Median: $241 (133% 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
Mclaren Health Plan	$94 - $331	52%
Meridian	$94 - $125	52%
Priority Health	$94 - $356	52%
UnitedHealthcare	$94 - $309	52%
Blue Cross Blue Shield	$96 - $329	53%
Aetna	$137 - $321	76%
Blue Care Network	$137 - $167	76%
Hap (Health Alliance Plan)	$137 - $285	76%
Medicare (plans)	$137 - $167	76%
Michigan Amish Medical Board	$137 - $167	76%
Molina	$137 - $181	76%
Northern Michigan Mennonite Group	$137 - $167	76%
Cigna	$195 - $356	108%
Asr Physicians Care Network	$205 - $285	113%
Hospice Of Michigan	$214	118%
Nomi Health	$219 - $331	121%
Employee Benefits Logistics	$232 - $284	128%
Provider Network Of America/Hma Group Health	$249 - $303	137%
Enterprise Group Planning Employee Benefit Plan	$285	157%
First Health/Coventry Health/Community Care Network	$285	157%
Medical Cost Savings Solution	$285	157%
Three Rivers Provider Network	$303	167%
Iba Health And Life Assurance Company	$328	181%
Cofinity	$331	183%
Preferred Medical Claim Solutions	$338	186%

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 $303.
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 Charlevoix Area 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.