CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Fostoria Community Hospital

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90791
Insurance Median: $311
Cash Discount Price: $382
vs. Medicare Baseline: 1.72x Medicare

The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Fostoria Community Hospital is $311. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $382. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.72x the Medicare baseline. Located in 501 Van Buren Street, Fostoria, OH.

Cash / Self-Pay

$382

Average discount available for prompt cash payment at this facility.

Insurance Median

$311

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: $382 (211%)

Insurance Median: $311 (172%)

Cash: $382 (211% of Medicare)

Ins. Median: $311 (172% 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
Meridian Health Plan Of Mi	$97	53%
Paramount Health Care	$124 - $311	68%
Health Value Management	$127 - $167	70%
Aetna	$129 - $393	71%
Blue Cross Blue Shield	$129 - $700	71%
Veterans Affairs	$129	71%
Health Alliance Plan	$130 - $440	72%
Buckeye Community Health Plan	$131 - $293	72%
Buckeye Community Health Plan Inc	$190 - $213	105%
Dayton Area Health Plan Dba Caresource	$244 - $288	135%
UnitedHealthcare	$290 - $351	160%
Amerihealth	$304	168%
Medical Mutual Of Ohio	$332 - $353	183%
Frontpath Health Coalition	$338	186%
Ohio Health Choice	$382	211%
Ohio Ppo Connect	$382 - $440	211%
Health Ohio Network	$464	256%
Connecticut General Life Insurance Company	$468	258%

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 $382.
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 Fostoria Community 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.