CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Allegheny Valley Hospital

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90791
  • Insurance Median: $124
  • Cash Discount Price: $97
  • vs. Medicare Baseline: 0.68x Medicare
The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Allegheny Valley Hospital is $124. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $97. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 0.68x the Medicare baseline. Located in 1301 Carlisle St, Natrona, PA.
Cash / Self-Pay
$97

Average discount available for prompt cash payment at this facility.

Insurance Median
$124

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: $97 (53%)
Insurance Median: $124 (68%)
Cash: $97 (53% of Medicare)
Ins. Median: $124 (68% 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
UnitedHealthcare $42 - $3,040 23%
Carelon $43 - $91 24%
Community Care Behavorial Health Healthchoices $98 - $122 54%
Community Care Behavorial Health University Of Pittsburgh Medical Center $98 - $122 54%
Highmark $100 - $342 55%
Univera $124 - $182 68%
Life Pittsburgh $140 - $155 77%
Medicare (plans) $149 - $159 82%
American Health Plans $154 - $155 85%
Martin'S Point $155 85%
Aetna $161 - $390 89%
Amerihealth $162 89%
Highmark Wholecare $164 90%
Humana $164 90%
Cigna $165 - $440 91%
Molina $168 93%
Medical Mutual $440 243%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1301 Carlisle St, Natrona, PA 15065
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals