CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Mercy Hospital of Buffalo

Billing Code: 90791 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$180

about 1.0× the $181 Medicare rate · typically $132–$199

modeled estimate · not a bill or quote

What this hospital charges insurers

$169

About the fair price

about $11 under the fair price · 0.9× Medicare

Medicare pays $181 Fair price $180 This hospital $169 Cash price $315 Hospital's list price $315

How we calculate the fair BaseRate →

How this hospital compares to other NY hospitals

Highest price of the 9 NY hospitals we have prices for — worth calling around.

Cheapest $143 Priciest $169

Black dot = this hospital, among the 9 NY hospitals with a price for this procedure. Full list below.

A fair price for a Psychiatric evaluation (first visit) is about $180 (about 1.0× the $181 Medicare rate). Mercy Hospital of Buffalo charges insurers about $169, or about $315 in cash — about the fair price. Located in Buffalo, NY.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$102 - $169	56%
Blue Cross Blue Shieldmajor	$69 - $186	38%
Aetnamajor	$153 - $169	84%
Cignamajor	$146 - $245	81%
Humanamajor	$153 - $169	84%
Amerigroup	$108 - $152	60%
Fidelis Care	$152 - $203	84%
Independent Health	$108 - $193	60%
MagnaCare	$169	93%
Molina	$242 - $341	133%
MVP Health Care	$110 - $177	61%
UPMC Health Plan	$136 - $262	75%
WellCare	$153 - $186	84%
+ 16 smaller / regional plans	$108 - $230

Government programs also on file: Medicare, Medicaid, Military & VA.

Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 315), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 90791.

Insurance Before you use insurance

Call your insurance company to confirm Mercy Hospital of Buffalo is in-network.
Ask your insurer whether prior approval is required for CPT code 90791.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Mercy Hospital of Buffalo

Compare: Psychiatric evaluation (first visit) at other NY hospitals

Insurance negotiated median for the same procedure, sorted lowest first.