CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Queens Hospital Center

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90791
Insurance Median: $255
Cash Discount Price: $184
vs. Medicare Baseline: 1.41x Medicare

The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Queens Hospital Center is $255. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $184. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.41x the Medicare baseline. Located in 82-68 164Th Street, Jamaica, NY.

Cash / Self-Pay

$184

Average discount available for prompt cash payment at this facility.

Insurance Median

$255

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: $184 (101%)

Insurance Median: $255 (141%)

Cash: $184 (101% of Medicare)

Ins. Median: $255 (141% 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
Healthfirst	$78 - $573	43%
Affinity	$137 - $573	76%
Carelon	$140 - $407	77%
United Behavioral Health	$143 - $280	79%
Blue Cross Blue Shield	$156 - $1,626	86%
Centerlight	$156 - $769	86%
Elderplan	$156 - $190	86%
Emblem	$156 - $977	86%
Fidelis	$156 - $573	86%
Wellcare	$158 - $168	87%
Centers Plan For Healthy Living	$162 - $198	89%
Hamaspik	$163	90%
Aetna	$166 - $1,171	92%
Oxford	$184 - $923	101%
United	$184 - $1,230	101%
Vaccn	$190	105%
Vnsny	$190 - $260	105%
Oscar	$194 - $285	107%
Metroplus	$234 - $573	129%
Amidacare	$255	141%
Senior Whole Health	$255	141%
Carelon (Amida Care)	$260	143%
Local 1199	$336 - $1,307	185%
Magnacare	$374 - $1,154	206%
Cigna	$1,154 - $1,500	636%
Multiplan	$1,230	678%
Villagecare Max	$1,307	721%

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 $184.
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 Queens Hospital 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.