CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Trident Medical Center

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90791
Insurance Median: $558
Cash Discount Price: $1,297
vs. Medicare Baseline: 3.08x Medicare

The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Trident Medical Center is $558. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,297. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 3.08x the Medicare baseline. Located in 9330 Medical Plaza Dr, Charleston, SC.

Cash / Self-Pay

$1,297

Average discount available for prompt cash payment at this facility.

Insurance Median

$558

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: $1,297 (715%)

Insurance Median: $558 (308%)

Cash: $1,297 (715% of Medicare)

Ins. Median: $558 (308% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 308% of the Medicare baseline (a markup of 208%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Absolute Total Care	$189 - $233	104%
Molina	$233	128%
Nhc Advantage	$246	136%
Pruitt Health	$246	136%
Blue Choice Health Plan	$253	140%
Blue Cross Blue Shield	$253 - $1,232	140%
Aetna	$276 - $613	152%
Sc State Employees	$348	192%
Medcost	$495 - $729	273%
United	$519 - $584	286%
Select Health	$558	308%
Employers Health Network	$584	322%
Occunet	$648	357%
Vocational Rehab	$700	386%
Humana	$843 - $973	465%
First Health	$947	522%
Evernorth	$1,038	572%
Multiplan	$1,102	608%
Prime Health	$1,102	608%
Novanet	$1,167	644%

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 $1,297.
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 Trident Medical Center 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.