CMS Price Transparency Data
Psychiatric evaluation (first visit)
Facility: Cannon Memorial Hospital
Billing Code: 90791 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 90791
- Insurance Median: $186
- Cash Discount Price: $207
- vs. Medicare Baseline: 1.03x Medicare
The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Cannon Memorial Hospital is $186. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $207. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.03x the Medicare baseline. Located in 123 W G Acker Drive, Pickens, SC.
Cash / Self-Pay
$207
Average discount available for prompt cash payment at this facility.
Insurance Median
$186
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: $207 (114%)
Insurance Median: $186 (103%)
Cash: $207 (114% of Medicare)
Ins. Median: $186 (103% 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 |
|---|---|---|
| Planned Administrators [886] | $70 - $178 | 39% |
| Employee Benefit Management Services [869] | $98 - $199 | 54% |
| Blue Choice Health Plan [922] | $100 - $200 | 55% |
| Blue Cross Blue Shield | $100 - $471 | 55% |
| Medicaid / KanCare | $102 - $732 | 56% |
| Absolute Total Care [58] | $104 - $732 | 57% |
| Humana | $107 - $732 | 59% |
| Select Health Of Sc [637] | $117 - $697 | 65% |
| Thomas Cooper & Company [315] | $124 - $178 | 68% |
| Aetna | $138 - $220 | 76% |
| Medicare (plans) | $138 - $349 | 76% |
| UnitedHealthcare | $138 - $349 | 76% |
| Vaccn - Va Community Care Network [16] | $138 | 76% |
| Veterans Administration [633] | $138 | 76% |
| Devoted Health Alt Payer [9401] | $140 | 77% |
| Devoted Health [94] | $140 | 77% |
| Absolute Total Care Mcr Plans Alt Payer [4101] | $142 | 78% |
| Absolute Total Care Mcr Plans [41] | $142 | 78% |
| Cigna | $142 - $349 | 78% |
| Molina Dual Options Alt Payer [1501] | $142 | 78% |
| Molina Dual Options [15] | $142 | 78% |
| First Choice Vip Careplus Alt Payer [3301] | $144 | 79% |
| First Choice Vip [33] | $144 | 79% |
| Nhc Advantage Alt Payer [6101] | $144 | 79% |
| Nhc Advantage [61] | $144 | 79% |
| Champva [604] | $145 | 80% |
| Tricare | $145 | 80% |
| Bright Health [11] | $162 | 89% |
| Bright Health Alt Payer [1001] | $165 | 91% |
| Other Hospital Payers [1991] | $185 - $349 | 102% |
| Geha [302] | $186 - $187 | 103% |
| Golden Rule Ins Co [584] | $186 - $187 | 103% |
| Phcs [940] | $188 - $364 | 104% |
| Nalc Health Benefit Plan [291] | $194 - $208 | 107% |
| Ambetter / Centene | $197 | 109% |
| Mail Handlers Benefit Plan [327] | $198 - $220 | 109% |
| Rural Carrier Benefit Plan [406] | $198 - $220 | 109% |
| First Choice Next [96] | $199 | 110% |
| Molina Marketplace [97] | $199 | 110% |
| Medcost [206] | $209 - $314 | 115% |
| Preferred Administrators [19] | $209 - $248 | 115% |
| Coventry Health [245] | $218 - $251 | 120% |
| Workers Compensation [622] | $225 | 124% |
| Edison Health Solutions [95] | $241 | 133% |
| Healthscope [98] | $241 | 133% |
| American Continental Ins [778] | $349 | 192% |
| American Republic Life Ins [722] | $349 | 192% |
| Business Office [6000] | $349 | 192% |
| Covid19 Hrsa Uninsured Testing And Treatment Fund [17] | $349 | 192% |
| First Health [946] | $349 | 192% |
| Guarantee Trust Life Insurance [236] | $349 | 192% |
| Home Health Infusion Payer [6001] | $349 | 192% |
| Manhattan Life Ins Co [932] | $349 | 192% |
| Miscellaneous Commercial [1] | $349 | 192% |
| New Era Life Ins Co [437] | $349 | 192% |
| Non-Contracted [22] | $349 | 192% |
| Physicians Mutual [773] | $349 | 192% |
| Reference Based Pricing/Limited Plan [21] | $349 | 192% |
| State Farm Ins Co [373] | $349 | 192% |
| Sterling Investors Life [244] | $349 | 192% |
| Supermed/Med Mutual Of Ohio [539] | $349 | 192% |
| United American Ins Co [277] | $349 | 192% |