CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Memorial Hospital for Cancer and Allied Diseases

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90791
Insurance Median: $270
Cash Discount Price: $497
vs. Medicare Baseline: 1.49x Medicare

The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Memorial Hospital for Cancer and Allied Diseases is $270. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $497. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.49x the Medicare baseline. Located in 1275 York Ave, New York, NY.

Cash / Self-Pay

$497

Average discount available for prompt cash payment at this facility.

Insurance Median

$270

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: $497 (274%)

Insurance Median: $270 (149%)

Cash: $497 (274% of Medicare)

Ins. Median: $270 (149% 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
Emblem	$60 - $649	33%
Aetna	$95 - $300	52%
Healthfirst	$102 - $539	56%
Fidelis	$156 - $606	86%
Metroplus	$156 - $165	86%
Empire	$163 - $467	90%
Magnacare	$163 - $592	90%
Oxford	$168 - $549	93%
Urn	$180 - $577	99%
Cigna	$194 - $438	107%
6 Degrees Health	$198 - $592	109%
UnitedHealthcare	$198 - $567	109%
Multiplan	$229 - $666	126%

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 $497.
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 Memorial Hospital for Cancer and Allied Diseases 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.