CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Carolina East Medical Center

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90791
  • Insurance Median: $209
  • Cash Discount Price: $169
  • vs. Medicare Baseline: 1.15x Medicare
The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Carolina East Medical Center is $209. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $169. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.15x the Medicare baseline. Located in 2000 Neuse Blvd, New Bern, NC.
Cash / Self-Pay
$169

Average discount available for prompt cash payment at this facility.

Insurance Median
$209

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: $169 (93%)
Insurance Median: $209 (115%)
Cash: $169 (93% of Medicare)
Ins. Median: $209 (115% 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
Pamlico Co Jail-All Plans $66 - $83 36%
UnitedHealthcare $88 - $222 49%
Craven Co. Jail Systems - All Plans $105 - $191 58%
Humana $136 - $170 75%
Inclusive Health (Nchirp)-All Plans $136 - $170 75%
Tricare $136 - $312 75%
Medcost Ppo Employees And Retirees $164 - $205 90%
Medcost Ppo Ultra (Employees) $164 - $195 90%
Blue Cross Blue Shield $175 - $214 97%
Medcost Ppo City Employees $182 - $227 100%
Medcost Ppo County Employee $189 - $236 104%
Benefit Mgmt, Svcs-All Plans $212 - $265 117%
Medcost Benefit Svc-All Other Plans $221 - $276 122%
Aetna $222 - $276 122%
Acs Consult Svc Inc-All Plans $226 - $282 125%
Medcost Ppo Standard $226 - $282 125%
Cigna $228 - $284 126%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2000 Neuse Blvd, New Bern, NC 28560
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals