CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Artesia General Hospital

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90791
Insurance Median: $197
Cash Discount Price: $226
vs. Medicare Baseline: 1.09x Medicare

The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Artesia General Hospital is $197. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $226. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.09x the Medicare baseline. Located in 702 N 13Th Street, Artesia, NM.

Cash / Self-Pay

$226

Average discount available for prompt cash payment at this facility.

Insurance Median

$197

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: $226 (125%)

Insurance Median: $197 (109%)

Cash: $226 (125% of Medicare)

Ins. Median: $197 (109% 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
Zelis	$59 - $187	33%
Presbyterian Health Plan	$80 - $156	44%
First Health	$84 - $381	46%
Blue Cross Blue Shield	$124 - $254	68%
Molina Healthcare Of New Mexico	$126 - $262	69%
UnitedHealthcare	$126 - $320	69%
Geha	$152 - $338	84%
Omni Networks	$152 - $296	84%
Triwest	$153	84%
Humana	$156 - $171	86%
Vistacare Hospice	$156	86%
Three Rivers Provider Network	$163 - $317	90%
Cigna	$184 - $381	101%
Galaxy Health	$195 - $381	108%
One Health Plan	$195 - $381	108%
Multiplan	$197 - $385	109%
United Payors & United Providers	$202 - $393	111%
Providence Risk & Insurance Services	$206 - $402	114%
New Mexico Health Connections	$265	146%

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 $226.
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 Artesia General Hospital 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.