CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Atrium Health Cleveland

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90791
  • Insurance Median: $107
  • Cash Discount Price: $70
  • vs. Medicare Baseline: 0.59x Medicare
The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Atrium Health Cleveland is $107. 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 0.59x the Medicare baseline. Located in 201 E Grover St, Shelby, NC.
Cash / Self-Pay
$70

Average discount available for prompt cash payment at this facility.

Insurance Median
$107

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: $107 (59%)
Cash: $70 (39% of Medicare)
Ins. Median: $107 (59% 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.

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
Partners $19 - $97 10%
Amerihealth Caritas $20 - $97 11%
Carolina Complete Health $20 - $97 11%
Healthy Blue $20 - $97 11%
Vaya $20 - $97 11%
Wellcare $20 - $97 11%
Alliance $21 - $97 12%
Trillium $21 - $96 12%
UnitedHealthcare $29 - $320 16%
Aetna $37 - $378 20%
Blue Cross Blue Shield $43 - $307 24%
Ambetter / Centene $44 - $214 24%
Cigna $60 - $268 33%
Employers Health Network $62 - $245 34%
Physician Reach Out $70 - $175 39%
Medcost $78 - $322 43%
Magellan $83 46%
Gmmi $90 - $263 50%
Quik Trip $90 - $263 50%
Carolina Behavioral Health $100 - $111 55%
Healthgram $111 - $267 61%
Choicecare $114 - $246 63%
First Health $118 - $298 65%
Lifesynch Community Choice Care $118 - $298 65%
Private Health Care Systems $125 - $316 69%
Beechstreet $128 - $323 71%
Multiplan $132 - $280 73%
Humana $144 - $154 79%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 201 E Grover St, Shelby, NC 28150
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals