CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Mercy Medical Center

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90791
  • Insurance Median: $165
  • Cash Discount Price: $214
  • vs. Medicare Baseline: 0.91x Medicare
The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Mercy Medical Center is $165. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $214. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 0.91x the Medicare baseline. Located in 1320 Mercy Drive Nw, Canton, OH.
Cash / Self-Pay
$214

Average discount available for prompt cash payment at this facility.

Insurance Median
$165

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: $214 (118%)
Insurance Median: $165 (91%)
Cash: $214 (118% of Medicare)
Ins. Median: $165 (91% 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
United $77 - $447 42%
Caresource $79 - $144 44%
Buckeye $81 - $144 45%
Amerihealth $85 - $154 47%
Molina $85 - $147 47%
Summacare $92 - $968 51%
Oscar $99 - $369 55%
Cc Ehp $131 - $133 72%
The Health Plan $134 - $329 74%
Aultcare $135 - $163 74%
Aetna $142 - $1,383 78%
Blue Cross Blue Shield $142 - $356 78%
Cigna $142 - $243 78%
Humana $142 - $148 78%
Mmo $146 - $968 81%
Amish Community Aid Plan $148 - $164 82%
Communicare $149 - $156 82%
Perennial Health $153 - $160 84%
Zing Health $156 - $163 86%
Ohcp $160 - $538 88%
Immergrun $164 - $1,037 90%
Omas $164 - $692 90%
Ohio Healthy $178 98%
Php $197 109%
Phphi $197 - $830 109%
Gms $230 - $968 127%
Medical Benefit Corp $230 127%
Consociate Health $247 136%
Frontpath $296 163%
Managed Care Services $296 163%
Multiplan $296 - $1,245 163%
Tertiary Care Network $296 163%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1320 Mercy Drive Nw, Canton, OH 44708
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals