CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Raritan Bay Medical Center

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90791
  • Insurance Median: $611
  • Cash Discount Price: $178
  • vs. Medicare Baseline: 3.37x Medicare
The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Raritan Bay Medical Center is $611. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $178. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 3.37x the Medicare baseline. Located in 530 New Brunswick Ave, Perth Amboy, NJ.
Cash / Self-Pay
$178

Average discount available for prompt cash payment at this facility.

Insurance Median
$611

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: $178 (98%)
Insurance Median: $611 (337%)
Cash: $178 (98% of Medicare)
Ins. Median: $611 (337% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 337% of the Medicare baseline (a markup of 237%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Aetna $105 - $711 58%
Clover $142 78%
Seoul Medical Group $164 90%
Blue Cross Blue Shield $178 98%
Vaccn $178 98%
Wellcare $178 98%
United Community/Americhoice $187 103%
Amerigroup $190 105%
UnitedHealthcare $214 - $956 118%
Karna $247 136%
Oxford $389 215%
Qualcare $525 - $717 290%
Activecare First McO $592 326%
Bergen Risk $592 326%
Horizon $604 - $763 333%
Cigna $632 - $755 349%
Multiplan - PHCS $672 371%
Amerihealth $684 - $769 377%
Brighton Health Plan $711 392%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 530 New Brunswick Ave, Perth Amboy, NJ 08861
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals