CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Lecom Medical Center and Behavioral Health Pav

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90791
  • Insurance Median: $245
  • Cash Discount Price: $245
  • vs. Medicare Baseline: 1.35x Medicare
The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Lecom Medical Center and Behavioral Health Pav is $245. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $245. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.35x the Medicare baseline. Located in 5515 Peach Street, Erie, PA.
Cash / Self-Pay
$245

Average discount available for prompt cash payment at this facility.

Insurance Median
$245

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: $245 (135%)
Insurance Median: $245 (135%)
Cash: $245 (135% of Medicare)
Ins. Median: $245 (135% 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
Upmc_Commercial $150 83%
Upmc_For_Life $150 83%
Upmc_For_Life_Hmo_Premier_Rx $150 83%
Upmc_Partner $150 83%
Upmc_Value $150 83%
Upmc_Value_Select $150 83%
UnitedHealthcare $176 97%
Blue Cross Blue Shield $184 - $259 101%
Healthchoice_Berks $245 135%
Healthchoice_Blair $245 135%
Healthchoice_Carbon_Monroe_Pike $245 135%
Healthchoice_Chester $245 135%
Healthchoice_Erie $245 135%
Healthchoice_Lycoming_Clinton $245 135%
Healthchoice_Northcentral $245 135%
Healthchoice_Northeast $245 135%
Healthchoice_Somerset_Bedford $245 135%
Healthchoice_York_Adams $245 135%
Medicare (plans) $245 135%
Aetna $269 148%
Cigna $338 186%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 5515 Peach Street, Erie, PA 16509
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals