CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Lancaster General Hospital

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90791
  • Insurance Median: $144
  • Cash Discount Price: $159
  • vs. Medicare Baseline: 0.79x Medicare
The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Lancaster General Hospital is $144. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $159. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 0.79x the Medicare baseline. Located in 555 North Duke Street, Lancaster, PA.
Cash / Self-Pay
$159

Average discount available for prompt cash payment at this facility.

Insurance Median
$144

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: $159 (88%)
Insurance Median: $144 (79%)
Cash: $159 (88% of Medicare)
Ins. Median: $144 (79% 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 $29 - $180 16%
Hospice And Community Care $30 - $32 17%
Upmc For You $40 - $42 22%
Old Order Group $43 - $54 24%
Lg Coresource/Lg Eliance $45 - $48 25%
Lancashire Hall $48 - $169 26%
Nursing Home Op Services $48 - $51 26%
Blue Cross Blue Shield $52 - $184 29%
Affilia Home Health $64 - $169 35%
Medicaid / KanCare $64 - $352 35%
Masonic Homes $67 - $169 37%
Highmark $77 - $179 42%
Gateway $80 - $84 44%
Tricare $95 - $101 52%
Eliance Health Solutions $102 - $108 56%
Highmark Commercial Preferred $106 - $169 58%
Aetna $108 - $182 60%
Cigna $120 - $186 66%
Ehp $130 - $139 72%
Upmc Commercial $130 - $144 72%
Devon $135 - $144 74%
Geisinger Commercial $135 - $144 74%
Intergroup Services $135 - $144 74%
Preferred Healthcare $135 - $144 74%
Medi-Share Christian Care $151 - $161 83%
Commercial Generic $159 - $169 88%
Highmark Commercial Non-Preferred $159 - $170 88%
Magellan $159 - $169 88%
Pa Health And Wellness Mcr $159 - $169 88%
United Behavioral Health $159 - $169 88%
Value Options $159 - $169 88%
Workers Compensation $159 - $169 88%
Albright Life $180 99%
Coatesville Va $180 99%
Hospice Generic $180 99%
Lebanon Veterans Hospital $180 99%
Medicare (plans) $180 - $199 99%
Amerihealth Caritas $184 101%
Health Partners Mcr Advantage $186 103%
Devoted Health $189 104%
Elap Employees $256 141%
Oscar Health Plan $352 194%
Claim Watcher Plus $541 298%
Claim Watcher $595 328%
Elap Other Groups $656 362%
Gift Of Life Donor Program $13,500 7445%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 555 North Duke Street, Lancaster, PA 17602
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals