CMS Price Transparency Data
Psychiatric evaluation (first visit)
Facility: Good Samaritan Hospital Medical Center
Billing Code: 90791 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 90791
- Insurance Median: $333
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 1.84x Medicare
The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Good Samaritan Hospital Medical Center is $333. 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 1.84x the Medicare baseline. Located in 1000 Montauk Highway, West Islip, NY.
Cash / Self-Pay
Unavailable
Average discount available for prompt cash payment at this facility.
Insurance Median
$333
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: $333 (184%)
Ins. Median: $333 (184% 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
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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 | $110 - $750 | 61% |
| Surest | $158 | 87% |
| Blue Cross Blue Shield | $186 - $298 | 103% |
| Aetna | $190 - $262 | 105% |
| Centerlight Healthcare | $190 - $333 | 105% |
| Centers Plan For Healthy Living | $190 | 105% |
| Elderplan Inc. | $190 - $333 | 105% |
| Emblem Health | $190 - $428 | 105% |
| Fidelis Care New York | $190 - $750 | 105% |
| Health Plus | $190 - $750 | 105% |
| Healthspring | $190 | 105% |
| Independent Health | $190 - $333 | 105% |
| Liberty Health | $190 | 105% |
| Longevity Health Plan | $190 | 105% |
| Medicare (plans) | $190 - $200 | 105% |
| Mvp Health Plans | $190 - $333 | 105% |
| Orthonet - Uniformed Services Family Health Plan | $190 | 105% |
| Pmc | $190 | 105% |
| Senior Whole Health | $190 - $333 | 105% |
| Tricare | $190 | 105% |
| Universal Healthcare | $190 | 105% |
| Us Family Health Plan | $190 | 105% |
| Veterans Affairs | $190 | 105% |
| Health First | $192 - $750 | 106% |
| Humana | $194 | 107% |
| Agewell New York | $197 | 109% |
| Partners Health Plan | $200 | 110% |
| Wellcare Health Plan Inc | $209 | 115% |
| Oscar Health | $215 | 119% |
| Zadroga | $243 | 134% |
| Apwu | $262 | 144% |
| Centivo | $262 | 144% |
| Cigna | $262 - $341 | 144% |
| Daniel H Cook | $262 | 144% |
| Mail Handlers Benefit Plan | $262 | 144% |
| Meritain Health | $262 | 144% |
| Nalc | $262 | 144% |
| Nippon Life Insurance Company Of America | $262 | 144% |
| Salvation Army | $262 | 144% |
| Samba | $262 | 144% |
| Self Pay | $298 | 164% |
| Affinity Health Plan | $333 - $750 | 184% |
| Medicaid / KanCare | $333 | 184% |
| Allied Wellfare Fund | $341 | 188% |
| American Group Administrators | $341 | 188% |
| Bakery & Confectionery Union | $341 | 188% |
| Brighton | $341 - $399 | 188% |
| Comprehensive Benefits Consultant | $341 | 188% |
| Guardian Life Insurance Company Of America | $341 | 188% |
| Maloney And Assoc | $341 | 188% |
| Multiplan | $341 | 188% |
| Performax | $341 | 188% |
| Phcs | $341 | 188% |
| Pomco | $341 | 188% |
| Tpa Inc | $341 | 188% |
| Unicare | $341 | 188% |
| United Employees Health Plan | $341 | 188% |
| Coventry | $388 - $446 | 214% |
| American Plan Administrators | $428 | 236% |
| Amerihealth Administrators | $428 | 236% |
| Benefit Services | $428 | 236% |
| Ghi Cbp Ny City Employee Alternate | $428 | 236% |
| International Benefit Administrator | $428 | 236% |
| Ultra Benefits Inc. | $428 | 236% |
| Galaxy | $472 | 260% |
| Three Rivers Provider Network | $472 | 260% |
| Aither Health | $525 | 290% |
| Alpha Care | $525 | 290% |
| Dentaquest | $525 | 290% |
| Local 1199 | $660 | 364% |