CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Univ. of Vermont - Fletcher Allen Health Care

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90791
Insurance Median: $249
Cash Discount Price: $469
vs. Medicare Baseline: 1.37x Medicare

The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Univ. of Vermont - Fletcher Allen Health Care is $249. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $469. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.37x the Medicare baseline. Located in 111 Colchester Ave, Burlington, VT.

Cash / Self-Pay

$469

Average discount available for prompt cash payment at this facility.

Insurance Median

$249

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: $469 (259%)

Insurance Median: $249 (137%)

Cash: $469 (259% of Medicare)

Ins. Median: $249 (137% 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
UnitedHealthcare	$94 - $779	52%
Mvp	$110 - $441	61%
Blue Cross Blue Shield	$131 - $514	72%
Humana	$131 - $162	72%
Aetna	$141 - $162	78%
St. Regis	$141 - $162	78%
Veterans Affairs Community Care Network	$141 - $162	78%
Cigna	$152 - $457	84%
Capital District Physicians' Health Plan	$162 - $351	89%
Fidelis Care	$162 - $178	89%
Martins Point	$165 - $166	91%
Wellpath	$198 - $258	109%
Ebpa	$361 - $403	199%
Harvard Pilgrim	$375	207%
Magnacare	$375	207%
Coventry	$399	220%
Nppn	$422	233%

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 $469.
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 Univ. of Vermont - Fletcher Allen Health Care 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.