Psychiatric evaluation (first visit)
Facility: Mercy Hospital of Buffalo
Billing Code: 90791 (CPT)
- CPT Billing Code: 90791
- Insurance Median: $156
- Cash Discount Price: $315
- vs. Medicare Baseline: 0.86x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Blue Cross Blue Shield | $69 - $186 | 38% |
| UnitedHealthcare | $102 - $169 | 56% |
| Medicaid / KanCare | $108 - $169 | 60% |
| Crime Victims [100176] | $108 - $152 | 60% |
| Amerigroup [350102] | $108 - $152 | 60% |
| Vna Option Mltc [350110] | $108 - $152 | 60% |
| Tuscarora Nation [550120] | $108 - $152 | 60% |
| Independent Health Essential [100166] | $108 - $152 | 60% |
| Excellus Rochester McD [350117] | $108 - $152 | 60% |
| Mvp Healthcare [100168] | $110 - $177 | 61% |
| Univera Healthcare [100169] | $127 - $215 | 70% |
| Univera Healthcare Essential [100170] | $127 - $146 | 70% |
| Medicare (plans) | $129 - $184 | 71% |
| VA Veterans Affairs [700001] | $131 - $169 | 72% |
| Beacon Essential [350122] | $131 - $175 | 72% |
| UPMC Health Plan [100181] | $136 - $262 | 75% |
| Cigna | $146 - $245 | 81% |
| Champ VA [700002] | $146 - $169 | 81% |
| Hospice [550001] | $146 - $169 | 81% |
| Covid19 Hrsa [45013] | $146 - $169 | 81% |
| Seneca Nation [450119] | $146 - $169 | 81% |
| Fallon Health [450115] | $146 - $169 | 81% |
| Tricare | $146 - $169 | 81% |
| Catholic Health Life Pace [400005] | $146 - $169 | 81% |
| Fidelis Essential [100163] | $152 - $203 | 84% |
| Humana | $153 - $169 | 84% |
| Wellcare Fidelis Dual [450451] | $153 - $178 | 84% |
| Fidelis Dual Advantage [450120] | $153 - $178 | 84% |
| Aetna | $153 - $169 | 84% |
| Ghi [100153] | $160 - $186 | 88% |
| Wellcare [450129] | $160 - $186 | 88% |
| Independent Health [100165] | $167 - $193 | 92% |
| Iha First Choice [800001] | $167 - $193 | 92% |
| Magnacare [100142] | $169 | 93% |
| Meritain [100063] | $169 | 93% |
| Fidelis Exchange [100164] | $175 - $203 | 97% |
| Beacon Health Options [100023] | $175 | 97% |
| Federal Workers Compensation [500100] | $230 | 127% |
| No Fault [114001] | $230 | 127% |
| Molina Essential [100167] | $242 - $341 | 133% |