CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Memorial Mission Hospital and Asheville Surgery Ce

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90791
Insurance Median: $152
Cash Discount Price: $440
vs. Medicare Baseline: 0.84x Medicare

The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Memorial Mission Hospital and Asheville Surgery Ce is $152. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $440. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 0.84x the Medicare baseline. Located in 509 Biltmore Ave, Asheville, NC.

Cash / Self-Pay

$440

Average discount available for prompt cash payment at this facility.

Insurance Median

$152

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: $440 (243%)

Insurance Median: $152 (84%)

Cash: $440 (243% of Medicare)

Ins. Median: $152 (84% 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
Blue Cross Blue Shield	$47 - $246	26%
United	$48 - $370	26%
Wellcare	$48 - $118	26%
Amerihealth	$49 - $119	27%
Partners Health Management	$49 - $121	27%
Vaya Health	$49 - $121	27%
Apex Health	$51 - $125	28%
Oscar	$91 - $223	50%
Aetna	$92 - $452	51%
Cigna	$95 - $311	52%
Medcost	$111 - $532	61%
Caresource	$112 - $275	62%
Amerihealth Caritas	$120 - $294	66%
Magellan	$153	84%
Magellan Behavioral Health	$153	84%
Multiplan	$204 - $500	112%
Avalon Administrative Services	$217 - $532	120%
Prime Health	$224 - $563	124%

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 $440.
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 Memorial Mission Hospital and Asheville Surgery Ce 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.