CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Flushing Hospital Medical Center

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90791
Insurance Median: $225
Cash Discount Price: $391
vs. Medicare Baseline: 1.24x Medicare

The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Flushing Hospital Medical Center is $225. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $391. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.24x the Medicare baseline. Located in 45Th Avenue and Parsons Boulevard, Flushing, NY.

Cash / Self-Pay

$391

Average discount available for prompt cash payment at this facility.

Insurance Median

$225

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: $391 (216%)

Insurance Median: $225 (124%)

Cash: $391 (216% of Medicare)

Ins. Median: $225 (124% 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
UnitedHealthcare	$91 - $220	50%
Ghi	$144	79%
1199 National Benefit Fund	$165	91%
United Behavioral Health	$168 - $263	93%
Empire Blue Priority	$184	101%
Healthfirst	$187	103%
Hotel Trades Council – Detox/Mental	$200	110%
Fidelis	$209 - $220	115%
Empire	$216 - $220	119%
Aetna	$220 - $320	121%
Beacon Health Strategies	$220	121%
Centerlight Healthcare	$220	121%
Metroplus	$220 - $243	121%
Humana	$223 - $234	123%
Elderplan	$225	124%
Vns	$225	124%
Wellcare Of Ny	$229	126%
Senior Whole Health	$234	129%
Valueoptions	$239	132%
Elderserve Health	$254	140%
Hamaspik Choice	$254	140%
Magnacare	$254 - $500	140%
Centers Plan For Healthy Living	$265	146%
Emblemhealth	$344	190%
Centivo	$456	251%
Create Health Plan	$476	262%
Hotel Trades Council	$1,912	1054%

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 $391.
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 Flushing Hospital 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.