CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Harlem Hospital Center

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90791
  • Insurance Median: $283
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.56x Medicare
The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Harlem Hospital Center is $283. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.56x the Medicare baseline. Located in 506 Lenox Avenue, New York, NY.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$283

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%)
Insurance Median: $283 (156%)
Ins. Median: $283 (156% 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 $125 - $573 69%
Carelon $140 - $407 77%
United Behavioral Health $143 - $280 79%
Emblem $156 - $977 86%
United $159 - $1,230 88%
Aetna $166 - $1,171 92%
Wellcare $168 93%
Oxford $184 - $923 101%
Blue Cross Blue Shield $190 - $1,626 105%
Elderplan $190 105%
Vaccn $190 105%
Vnsny $190 - $260 105%
Centers Plan For Healthy Living $198 109%
Fidelis $224 - $573 124%
Metroplus $234 - $573 129%
Amidacare $255 141%
Senior Whole Health $255 141%
Affinity $260 - $573 143%
Carelon (Amida Care) $260 143%
Oscar $285 157%
Magnacare $374 - $1,154 206%
Centerlight $769 424%
Local 1199 $796 - $1,307 439%
Cigna $1,154 - $1,500 636%
Multiplan $1,230 678%
Villagecare Max $1,307 721%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 506 Lenox Avenue, New York, NY 10037
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals