CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Uva Health Culpeper Medical Center

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90791
Insurance Median: $168
Cash Discount Price: $157
vs. Medicare Baseline: 0.93x Medicare

The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Uva Health Culpeper Medical Center is $168. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $157. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 0.93x the Medicare baseline. Located in 501 Sunset Lane, Culpeper, VA.

Cash / Self-Pay

$157

Average discount available for prompt cash payment at this facility.

Insurance Median

$168

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: $157 (87%)

Insurance Median: $168 (93%)

Cash: $157 (87% of Medicare)

Ins. Median: $168 (93% 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
Cigna	$77 - $210	42%
Beacon Health Options [40012]	$100	55%
Commercial Contracted Hb Only [40056]	$105	58%
Commercial Generic [40000]	$105 - $140	58%
Geha [40009]	$116 - $292	64%
UnitedHealthcare	$116 - $360	64%
Commercial Contracted Tpa [40055]	$120 - $140	66%
Umwa [40037]	$140	77%
Aetna	$148 - $176	82%
Healthsmart [40013]	$150	83%
Champva [50002]	$151	83%
Tricare	$151	83%
First Health Generic [40033]	$164	90%
Carefirst [30007]	$166	92%
Gateway Health Alliance [40034]	$170	94%
Multiplan Generic [40035]	$170 - $239	94%
Vhn Generic [40040]	$170 - $239	94%
Onenet Workers Comp Generic [60010]	$175	97%
Sentara Behavioral Health [40052]	$244 - $595	135%
Sentara [40021]	$244 - $595	135%
Kaiser Permenente [40014]	$283	156%

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 $157.
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 Uva Health Culpeper 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.