CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Charleston Area Medical Center

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90791
Insurance Median: $190
Cash Discount Price: $372
vs. Medicare Baseline: 1.05x Medicare

The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Charleston Area Medical Center is $190. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $372. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.05x the Medicare baseline. Located in 501 Morris Street, Charleston, WV.

Cash / Self-Pay

$372

Average discount available for prompt cash payment at this facility.

Insurance Median

$190

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: $372 (205%)

Insurance Median: $190 (105%)

Cash: $372 (205% of Medicare)

Ins. Median: $190 (105% 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
Aetna	$97 - $266	53%
The Health Plan Of West Virginia Inc.	$97 - $269	53%
Unicare Health Plan Of West Virginia Inc.	$97 - $113	53%
Tricare	$163 - $283	90%
Triwest Va	$163 - $176	90%
Blue Cross Blue Shield	$168 - $247	93%
Choicecare Network	$168 - $266	93%
Optimum Choice Inc.	$168 - $181	93%
UnitedHealthcare	$168 - $266	93%
West Virginia Senior Advantage Inc.	$176 - $190	97%
City Of Charleston	$203 - $218	112%
Naphcare	$230 - $271	127%
Integrated Medical Solutions	$243 - $244	134%
Caresource	$252 - $271	139%
Cigna	$252 - $467	139%
Three Rivers Providers Network	$263 - $458	145%
Healthsmart	$266 - $463	147%
Multiplan	$266 - $463	147%

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 $372.
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 Charleston Area 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.