CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Reading Hospital

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90791
  • Insurance Median: $163
  • Cash Discount Price: $290
  • vs. Medicare Baseline: 0.90x Medicare
The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Reading Hospital is $163. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $290. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 0.90x the Medicare baseline. Located in 420 S 5Th Avenue, West Reading, PA.
Cash / Self-Pay
$290

Average discount available for prompt cash payment at this facility.

Insurance Median
$163

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: $290 (160%)
Insurance Median: $163 (90%)
Cash: $290 (160% of Medicare)
Ins. Median: $163 (90% 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 $33 - $335 18%
Geisinger $47 - $262 26%
United Behavioral Health $110 - $150 61%
Humana $115 - $139 63%
Aetna $134 - $298 74%
Blue Cross Blue Shield $134 - $266 74%
Highmark $135 - $169 74%
Upmc $135 - $224 74%
Amerihealth Caritas $137 76%
Health America $139 77%
Devoted Health $141 78%
Health Partners $142 - $179 78%
Pa Health & Wellness $142 - $216 78%
Gateway $144 - $179 79%
Quest Behavioral Health $150 83%
Magellan $152 84%
Pma $160 - $166 88%
Lehigh Valley Health Network $180 - $202 99%
Cigna $246 - $275 136%
First Health $269 - $319 148%
Berkshire $300 - $310 165%
Blue Ridge $380 - $393 210%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 420 S 5Th Avenue, West Reading, PA 19611
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals