CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Carolinas Rehabilitation

Billing Code: 90791 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$164

about 0.9× the $181 Medicare rate · typically $132–$174

modeled estimate · not a bill or quote

Medicare pays $181 Fair price $164 Cash price $70 Hospital's list price $139

How we calculate the fair BaseRate →

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$56 - $320	31%
Blue Cross Blue Shieldmajor	$48 - $307	26%
Aetnamajor	$66 - $378	36%
Cignamajor	$60 - $268	33%
Humanamajor	$144 - $164	79%
Ambetter (Centene)	$43 - $214	24%
AmeriHealth	$54 - $97	30%
Health Net	$62 - $245	34%
WellCare	$55 - $97	30%
+ 8 smaller / regional plans	$55 - $316

Excludes 3 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 70), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 90791.

Insurance Before you use insurance

Call your insurance company to confirm Carolinas Rehabilitation is in-network.
Ask your insurer whether prior approval is required for CPT code 90791.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

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Other Procedures at Carolinas Rehabilitation

Compare: Psychiatric evaluation (first visit) at other NC hospitals

Insurance negotiated median for the same procedure, sorted lowest first.