CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Columbia Memorial Hospital

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90791
  • Insurance Median: $166
  • Cash Discount Price: $213
  • vs. Medicare Baseline: 0.92x Medicare
The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Columbia Memorial Hospital is $166. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $213. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 0.92x the Medicare baseline. Located in 71 Prospect Avenue, Hudson, NY.
Cash / Self-Pay
$213

Average discount available for prompt cash payment at this facility.

Insurance Median
$166

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: $213 (117%)
Insurance Median: $166 (92%)
Cash: $213 (117% of Medicare)
Ins. Median: $166 (92% 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
Medicaid / KanCare $51 - $235 28%
UnitedHealthcare $60 - $241 33%
Blue Cross Blue Shield $86 - $2,449 47%
Mvp $106 - $494 58%
Cdphp $111 - $529 61%
Medicare (plans) $113 - $178 62%
Tricare $113 - $178 62%
Hamaspik $125 - $320 69%
Fidelis $144 - $529 79%
Blue Shield Highmark $152 - $192 84%
Aetna $153 - $315 84%
Cigna $160 - $189 88%
Magnacare $164 - $336 90%
Empire Plan Nyship $181 100%
Multiplan $192 - $393 106%
Emblem Health Ghi $207 - $243 114%
Herrington Diversified Pdh $213 - $285 117%
Mvp Commercial $213 - $437 117%
Emblem $228 - $369 126%
Blue Shield $276 - $475 152%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 71 Prospect Avenue, Hudson, NY 12534
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals