CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Suny/Stony Brook University Hospital

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90791
Insurance Median: $250
Cash Discount Price: $2,679
vs. Medicare Baseline: 1.38x Medicare

The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Suny/Stony Brook University Hospital is $250. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,679. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.38x the Medicare baseline. Located in Health Sciences Center SUNY, Stony Brook, NY.

Cash / Self-Pay

$2,679

Average discount available for prompt cash payment at this facility.

Insurance Median

$250

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: $2,679 (1477%)

Insurance Median: $250 (138%)

Cash: $2,679 (1477% of Medicare)

Ins. Median: $250 (138% 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	$165	91%
Aetna	$220 - $2,419	121%
Blue Cross Blue Shield	$220	121%
Elderplan	$220	121%
Fidelis Care	$220	121%
Healthfirst Health Plan	$220	121%
UnitedHealthcare	$220 - $4,255	121%
Emblemhealth Hip Of Ny	$225 - $2,110	124%
Beacon Health Options	$231	127%
Agewell New York	$243	134%
Healthfirst Essential Plan 1/2	$250	138%
Healthfirst Essential Plan 3/4	$250	138%
Centerlight	$287	158%
Partners Health Plan	$287	158%
Emblemhealth Hip Of Ny Select Care	$1,584	873%
Cigna	$1,789	987%
Emblemhealth Ghi	$1,838	1014%
Brighton All Payer	$2,422	1336%
Oxford Freedom And Liberty	$2,762	1523%

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 $2,679.
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 Suny/Stony Brook University Hospital 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.