CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Carolinas Medical Center/Behav Health

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90791
  • Insurance Median: $101
  • Cash Discount Price: $70
  • vs. Medicare Baseline: 0.56x Medicare
The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Carolinas Medical Center/Behav Health is $101. 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 0.56x the Medicare baseline. Located in 1000 Blythe Blvd, Charlotte, NC.
Cash / Self-Pay
$70

Average discount available for prompt cash payment at this facility.

Insurance Median
$101

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: $101 (56%)
Cash: $70 (39% of Medicare)
Ins. Median: $101 (56% 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
Aetna $26 - $378 14%
Blue Cross Blue Shield $26 - $307 14%
Cigna $26 - $268 14%
Humana $26 - $287 14%
Amerihealth Caritas $30 - $97 17%
Alliance $31 - $97 17%
Carolina Complete Health $31 - $139 17%
Healthy Blue $31 - $97 17%
Partners $31 - $96 17%
Sandhills $31 - $96 17%
Vaya $31 - $97 17%
Wellcare $31 - $97 17%
Trillium $32 - $97 18%
Ambetter / Centene $40 - $214 22%
Medcost $43 - $322 24%
UnitedHealthcare $45 - $320 25%
Employers Health Network $62 - $245 34%
Physician Reach Out $70 - $175 39%
Magellan $83 46%
Gmmi $90 - $263 50%
Molina $90 50%
Quik Trip $90 - $263 50%
Carolina Behavioral Health $100 - $111 55%
Choicecare $100 - $246 55%
First Health $111 - $308 61%
Healthgram $111 - $267 61%
Private Health Care Systems $111 - $287 61%
Provider Select $113 - $284 62%
Lifesynch Community Choice Care $114 - $287 63%
Beechstreet $121 - $316 67%
Multiplan $125 - $280 69%
United $156 86%
Ortho Carolina $176 - $201 97%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1000 Blythe Blvd, Charlotte, NC 28203
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals