CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Capital Health Medical Center - Hopewell

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90791
Insurance Median: $200
Cash Discount Price: $788
vs. Medicare Baseline: 1.10x Medicare

The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Capital Health Medical Center - Hopewell is $200. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $788. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.10x the Medicare baseline. Located in One Capital Way, Pennington, NJ.

Cash / Self-Pay

$788

Average discount available for prompt cash payment at this facility.

Insurance Median

$200

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: $788 (435%)

Insurance Median: $200 (110%)

Cash: $788 (435% of Medicare)

Ins. Median: $200 (110% 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
UnitedHealthcare	$32 - $1,018	18%
Medicaid / KanCare	$34	19%
Wellpoint	$34 - $200	19%
Aetna	$43 - $280	24%
Cigna	$68 - $591	37%
Blue Cross Blue Shield	$79 - $94	44%
Medicare (plans)	$181	100%
Clover	$200	110%
Humana	$204	112%
Fidelis	$281	155%
Oxford Benefit Plan	$361	199%
Multiplan	$670	369%
Horizon Nj Health	$712	393%

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 $788.
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 Capital Health Medical Center - Hopewell 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.