CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Geisinger-Lewistown Hospital

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90791
Insurance Median: $206
Cash Discount Price: $262
vs. Medicare Baseline: 1.14x Medicare

The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Geisinger-Lewistown Hospital is $206. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $262. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.14x the Medicare baseline. Located in 400 Highland Avenue, Lewistown, PA.

Cash / Self-Pay

$262

Average discount available for prompt cash payment at this facility.

Insurance Median

$206

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: $262 (144%)

Insurance Median: $206 (114%)

Cash: $262 (144% of Medicare)

Ins. Median: $206 (114% 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
Medicaid / KanCare	$26	14%
Geisinger Family Plan	$28	15%
Amerihealth	$29	16%
Upmc Health Plan	$31 - $11,890	17%
Health Partners	$32	18%
Upmc Chip	$33	18%
Blue Cross Blue Shield	$139 - $470	77%
Geisinger Health Plan	$156 - $730	86%
Medicare (plans)	$156	86%
Advantra	$157	87%
Humana	$157	87%
Aetna	$173 - $206	95%
Cigna	$183 - $222	101%
UnitedHealthcare	$187	103%
Christian Healthcare Ministries	$212	117%
Christian Health Aid	$338	186%
Three Rivers Provider Network Inc.	$338	186%
Multiplan	$360	199%
Ambetter / Centene	$374	206%
Healthsmart Payors Organization	$381	210%

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 $262.
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 Geisinger-Lewistown 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.