CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: North Carolina Baptist Hospital

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90791
  • Insurance Median: $106
  • Cash Discount Price: $152
  • vs. Medicare Baseline: 0.58x Medicare
The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at North Carolina Baptist Hospital is $106. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $152. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 0.58x the Medicare baseline. Located in Medical Center Boulevard, Winston-Salem, NC.
Cash / Self-Pay
$152

Average discount available for prompt cash payment at this facility.

Insurance Median
$106

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: $152 (84%)
Insurance Median: $106 (58%)
Cash: $152 (84% of Medicare)
Ins. Median: $106 (58% 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
Medcost $58 - $207 32%
Blue Cross Blue Shield $61 - $156 34%
Amerihealth $67 - $84 37%
Carolina Complete $67 - $71 37%
Health Blue $67 - $71 37%
Partners $67 - $71 37%
Vaya $67 - $71 37%
Alliance $68 - $72 37%
UnitedHealthcare $68 - $156 37%
Wellcare $68 - $156 37%
Trillium $69 - $73 38%
Aetna $70 - $265 39%
Ambetter / Centene $80 - $84 44%
Oscar $88 - $112 49%
Cigna $90 - $187 50%
Apex $156 86%
Devoted $156 86%
Healthteam $156 86%
Humana $157 - $171 87%
Medicare (plans) $157 87%
Directnet $174 - $184 96%
Liberty $179 99%
Cone Health $206 - $218 114%
Healthgram $206 - $218 114%
First Carolina Care $236 - $250 130%
Private Healthcare Systems $242 - $256 133%
Multiplan $266 - $281 147%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: Medical Center Boulevard, Winston-Salem, NC 27157
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals