CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Fairfield Medical Center

Billing Code: 90791 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$220

about 1.2× the $181 Medicare rate · typically $157–$366

modeled estimate · not a bill or quote

What this hospital charges insurers

$192

Below the fair price — a good deal

about $28 under the fair price · 1.1× Medicare

Medicare pays $181 Fair price $220 This hospital $192 Cash price $248 Hospital's list price $550

How we calculate the fair BaseRate →

How this hospital compares to other OH hospitals

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

Cheapest $110 Priciest $192

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

A fair price for a Psychiatric evaluation (first visit) is about $220 (about 1.2× the $181 Medicare rate). Fairfield Medical Center charges insurers about $192, or about $248 in cash — below the fair price — a good deal. Located in Lancaster, OH.

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	$171 - $6,096	94%
Blue Cross Blue Shieldmajor	$168 - $26,250	93%
Aetnamajor	$168 - $5,975	93%
Cignamajor	$453	250%
Humanamajor	$154 - $5,975	85%
AmeriHealth	$192	106%
CareSource	$175 - $7,925	97%
Medical Mutual	$168 - $33,500	93%
Molina	$171 - $10,059	94%
Oscar Health	$317 - $6,242	175%
+ 8 smaller / regional plans	$168 - $9,449

Government programs also on file: Medicare, Medicaid, 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 248), 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 Fairfield Medical Center 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 Fairfield Medical Center

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

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