CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: St Joseph's University Medical Center Inc

Billing Code: 90791 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$191

about 1.1× the $181 Medicare rate · typically $146–$244

modeled estimate · not a bill or quote

What this hospital charges insurers

$211

About the fair price

about $20 over the fair price · 1.2× Medicare

Medicare pays $181 Fair price $191 This hospital $211 Cash price $485 Hospital's list price $485

How we calculate the fair BaseRate →

How this hospital compares to other NJ hospitals

Highest price of the 9 NJ hospitals we have prices for — worth calling around.

Cheapest $152 Priciest $211

Black dot = this hospital, among the 9 NJ hospitals with a price for this procedure. Full list below.

A fair price for a Psychiatric evaluation (first visit) is about $191 (about 1.1× the $181 Medicare rate). St Joseph's University Medical Center Inc charges insurers about $211, or about $485 in cash — about the fair price. Located in Paterson, NJ.

What each insurance company pays

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

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

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna HumanaKaiser 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	$86 - $1,940	47%
Blue Cross Blue Shieldmajor	$95 - $600	52%
Aetnamajor	$100 - $430	55%
Cignamajor	$448 - $485	247%
Ambetter (Centene)	$147 - $316	81%
AmeriHealth	$147 - $309	81%
Clover Health	$147 - $211	81%
Fidelis Care	$60 - $221	33%
Health Net	$336 - $436	185%
MagnaCare	$340	187%
Oscar Health	$457	252%
+ 4 smaller / regional plans	$147 - $1,786

Excludes 2 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 485), 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 St Joseph's University Medical Center Inc 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 St Joseph's University Medical Center Inc

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

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