CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Montefiore Mount Vernon Hospital

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90791
  • Insurance Median: $222
  • Cash Discount Price: $335
  • vs. Medicare Baseline: 1.22x Medicare
The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Montefiore Mount Vernon Hospital is $222. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $335. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.22x the Medicare baseline. Located in 12 North 7Th Avenue, Mount Vernon, NY.
Cash / Self-Pay
$335

Average discount available for prompt cash payment at this facility.

Insurance Median
$222

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: $335 (185%)
Insurance Median: $222 (122%)
Cash: $335 (185% of Medicare)
Ins. Median: $222 (122% 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
Healthfirst $152 - $333 84%
Metroplus $154 - $368 85%
American Postal Workers $156 86%
UnitedHealthcare $156 - $222 86%
Amidacare $204 112%
Blue Cross Blue Shield $204 - $560 112%
Emblem $204 - $826 112%
Fidelis $204 - $357 112%
Medicaid / KanCare $204 112%
Molina Healthcare Of Ny Affinity $204 - $459 112%
Mvp $204 - $419 112%
Wellcare $206 - $226 114%
Hamaspik $214 - $221 118%
Point Comfort $222 122%
Villagecaremax $222 122%
Vnsny Choice $222 - $235 122%
Centerlight $228 - $244 126%
Partners Health Plan $233 128%
Vnsny Select Health $235 130%
Longevity $242 133%
Elderplan $244 135%
Humana $244 135%
Cigna $275 - $306 152%
Northwell $335 185%
Oscar $394 217%
Aetna $458 - $512 253%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 12 North 7Th Avenue, Mount Vernon, NY 10550
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals