CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Elizabethtown Community Hospital

Billing Code: 90791 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$158

about 0.9× the $181 Medicare rate · typically $123–$291

modeled estimate · not a bill or quote

What this hospital charges insurers

$164

About the fair price

about $6 over the fair price · 0.9× Medicare

Medicare pays $181 Fair price $158 This hospital $164 Cash price $623 Hospital's list price $623

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 $164

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

⚠ The cash price looks unusually high next to the insurance price — it may be the full list price, not a real cash discount. Call to confirm the self-pay rate.

A fair price for a Psychiatric evaluation (first visit) is about $158 (about 0.9× the $181 Medicare rate). Elizabethtown Community Hospital charges insurers about $164, or about $623 in cash — about the fair price. Located in Elizabethtown, NY.

What each insurance company pays

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

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

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Humana CignaKaiser 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	$115 - $398	63%
Blue Cross Blue Shieldmajor	$124 - $226	68%
Aetnamajor	$141 - $530	78%
Humanamajor	$134	74%
Fidelis Care	$120 - $192	66%
Harvard Pilgrim	$498	275%
MagnaCare	$498	275%
MVP Health Care	$110 - $310	61%
+ 3 smaller / regional plans	$155 - $267

Government programs also on file: Military & VA.

Excludes 2 rental-network / third-party entries (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 623), 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 Elizabethtown Community Hospital 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 Elizabethtown Community Hospital

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

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