CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Cheshire Medical Center

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90791
Insurance Median: $257
Cash Discount Price: $160
vs. Medicare Baseline: 1.42x Medicare

The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Cheshire Medical Center is $257. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $160. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.42x the Medicare baseline. Located in 580 Court Street, Keene, NH.

Cash / Self-Pay

$160

Average discount available for prompt cash payment at this facility.

Insurance Median

$257

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: $160 (88%)

Insurance Median: $257 (142%)

Cash: $160 (88% of Medicare)

Ins. Median: $257 (142% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Amerihealth Caritas Nh	$71 - $93	39%
Wellsense Health Plan	$80 - $182	44%
Granite State Health Plan	$93 - $97	51%
Mass General Brigham Health Plan	$118 - $581	65%
Harvard Pilgrim Health Care Of Ne	$124 - $264	68%
Aetna	$147 - $397	81%
Ambetter / Centene	$149 - $182	82%
Blue Cross Blue Shield	$157 - $545	87%
Cigna	$157 - $431	87%
Martin'S Point Generations Advantage	$157 - $182	87%
Martin'S Point Health Care	$157 - $182	87%
Mvp	$157 - $431	87%
UnitedHealthcare	$157 - $460	87%
Wellcare Health Plans	$157 - $182	87%
Maine Community Health Options	$261	144%
Tufts Health Plan	$371 - $481	205%
First Health/Hcvm	$494	272%
Phcs	$523	288%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $160.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 90791.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Cheshire Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 90791.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.