CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: St Joseph's University Medical Center Inc

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90791
  • Insurance Median: $215
  • Cash Discount Price: $485
  • vs. Medicare Baseline: 1.19x Medicare
The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at St Joseph's University Medical Center Inc is $215. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $485. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.19x the Medicare baseline. Located in 703 Main St, Paterson, NJ.
Cash / Self-Pay
$485

Average discount available for prompt cash payment at this facility.

Insurance Median
$215

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: $485 (267%)
Insurance Median: $215 (119%)
Cash: $485 (267% of Medicare)
Ins. Median: $215 (119% 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
Fidelis Care of New Jersey $60 - $221 33%
UnitedHealthcare $86 - $1,940 47%
Wellpoint $95 - $211 52%
Aetna $100 - $430 55%
Ambetter / Centene $147 - $316 81%
Amerihealth $147 - $309 81%
Clover Health $147 - $211 81%
Horizon New Jersey Total Care $147 - $211 81%
Horizon New Jersey Health $150 - $381 83%
Amerihealth Behavioral Health $185 - $261 102%
Blue Cross Blue Shield $190 - $600 105%
Multiplan $220 - $364 121%
Longevity Health Plan $242 133%
Private Healthcare Systems $291 - $315 160%
Consumer Health Network $336 - $436 185%
Magnacare $340 187%
Cigna $448 - $485 247%
Oscar $457 252%
Oxford $1,786 985%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 703 Main St, Paterson, NJ 07503
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals