CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Transylvania Regional Hospital, Inc

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90791
  • Insurance Median: $176
  • Cash Discount Price: $424
  • vs. Medicare Baseline: 0.97x Medicare
The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Transylvania Regional Hospital, Inc is $176. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $424. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 0.97x the Medicare baseline. Located in 90 Hospital Drive Po Box 1116, Brevard, NC.
Cash / Self-Pay
$424

Average discount available for prompt cash payment at this facility.

Insurance Median
$176

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: $424 (234%)
Insurance Median: $176 (97%)
Cash: $424 (234% of Medicare)
Ins. Median: $176 (97% 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
Blue Cross Blue Shield $80 - $176 44%
United $81 - $191 45%
Wellcare $82 45%
Amerihealth $83 46%
Partners Health Management $84 46%
Vaya Health $84 46%
Apex Health $85 47%
Aetna $110 - $306 61%
Cigna $155 - $216 85%
Amerihealth Caritas $174 96%
Caresource $186 103%
Oscar $193 106%
Medcost $198 - $360 109%
Magellan $254 140%
Magellan Behavioral Health $254 140%
Multiplan $339 187%
Avalon Administrative Services $360 199%
Prime Health $373 - $381 206%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 90 Hospital Drive Po Box 1116, Brevard, NC 28712
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals