CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Carolinas Medical Center-Northeast

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90791
Insurance Median: $104
Cash Discount Price: $70
vs. Medicare Baseline: 0.57x Medicare

The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Carolinas Medical Center-Northeast is $104. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $70. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 0.57x the Medicare baseline. Located in 920 Church St N, Concord, NC.

Cash / Self-Pay

$70

Average discount available for prompt cash payment at this facility.

Insurance Median

$104

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: $70 (39%)

Insurance Median: $104 (57%)

Cash: $70 (39% of Medicare)

Ins. Median: $104 (57% 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
Carolina Complete Health	$17 - $97	9%
Healthy Blue	$17 - $97	9%
Wellcare	$17 - $97	9%
Alliance	$18 - $97	10%
Partners	$18 - $96	10%
Trillium	$18 - $96	10%
UnitedHealthcare	$18 - $320	10%
Vaya	$18 - $97	10%
Aetna	$37 - $378	20%
Blue Cross Blue Shield	$38 - $307	21%
Ambetter / Centene	$40 - $214	22%
Cigna	$60 - $268	33%
Employers Health Network	$62 - $245	34%
Physician Reach Out	$70 - $175	39%
Medcost	$75 - $322	41%
Magellan	$83	46%
Gmmi	$90 - $263	50%
Quik Trip	$90 - $263	50%
Amerihealth Caritas	$97	53%
Carolina Behavioral Health	$100 - $111	55%
Healthgram	$111 - $267	61%
Private Health Care Systems	$111 - $280	61%
Choicecare	$114 - $246	63%
Lifesynch Community Choice Care	$114 - $287	63%
First Health	$118 - $298	65%
Beechstreet	$125 - $316	69%
Multiplan	$132 - $280	73%
Humana	$144 - $156	79%
Ortho Carolina	$176 - $191	97%

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 $70.
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 Carolinas Medical Center-Northeast 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.