CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Lodi Community Hospital

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90791
  • Insurance Median: $203
  • Cash Discount Price: $214
  • vs. Medicare Baseline: 1.12x Medicare
The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Lodi Community Hospital is $203. 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 1.12x the Medicare baseline. Located in 225 Elyria Street, Lodi, OH.
Cash / Self-Pay
$214

Average discount available for prompt cash payment at this facility.

Insurance Median
$203

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: $203 (112%)
Cash: $214 (118% of Medicare)
Ins. Median: $203 (112% 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
Humana $99 55%
Mmo $99 - $176 55%
Oscar $99 - $126 55%
Summacare $99 - $202 55%
United $99 - $235 55%
Aetna $112 - $329 62%
The Health Plan $132 - $263 73%
Amish Community Aid Plan $148 - $164 82%
Ohcp $160 88%
Blue Cross Blue Shield $161 - $269 89%
UnitedHealthcare $161 - $204 89%
Aultcare $164 90%
Omas $164 90%
Ohio Healthy $178 98%
Php $197 109%
Phphi $197 109%
Upmc $197 109%
Cigna $212 117%
Buckeye $213 117%
Caresource $213 117%
Cc Ehp $221 122%
Molina $223 123%
Gms $230 127%
Medical Benefit Corp $230 127%
Amerihealth $234 129%
Consociate Health $247 136%
Frontpath $296 163%
Managed Care Services $296 163%
Multiplan $296 163%
Tertiary Care Network $296 163%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 225 Elyria Street, Lodi, OH 44254
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals