CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Jersey Shore University Medical Center

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90791
Insurance Median: $582
Cash Discount Price: $178
vs. Medicare Baseline: 3.21x Medicare

The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Jersey Shore University Medical Center is $582. 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 3.21x the Medicare baseline. Located in 1945 Rte 33, Neptune, NJ.

Cash / Self-Pay

$178

Average discount available for prompt cash payment at this facility.

Insurance Median

$582

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: $582 (321%)

Cash: $178 (98% of Medicare)

Ins. Median: $582 (321% 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 321% of the Medicare baseline (a markup of 221%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Aetna	$137 - $742	76%
Clover	$148	82%
Horizon	$167 - $824	92%
Blue Cross Blue Shield	$178	98%
UnitedHealthcare	$178 - $549	98%
Vaccn	$178	98%
Wellcare	$178	98%
United Community/Americhoice	$187	103%
Seoul Medical Group	$190	105%
Karna	$241	133%
Oxford	$426	235%
Qualcare	$491 - $748	271%
Beacon	$618	341%
Bergen Risk	$618	341%
Cigna	$659 - $788	363%
Activecare First McO	$700	386%
Multiplan - PHCS	$700	386%
Amerihealth	$720 - $815	397%
Brighton Health Plan	$742	409%

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 $178.
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 Jersey Shore University 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.