CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Margaretville Memorial Hospital

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90791
  • Insurance Median: $226
  • Cash Discount Price: $399
  • vs. Medicare Baseline: 1.25x Medicare
The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Margaretville Memorial Hospital is $226. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $399. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.25x the Medicare baseline. Located in 42084 State Highway 28, Margaretville, NY.
Cash / Self-Pay
$399

Average discount available for prompt cash payment at this facility.

Insurance Median
$226

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: $399 (220%)
Insurance Median: $226 (125%)
Cash: $399 (220% of Medicare)
Ins. Median: $226 (125% 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.

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
Blue Cross Blue Shield $170 - $226 94%
Mvp Gold (McR) $176 - $186 97%
UnitedHealthcare $176 - $384 97%
Hamaspik (McR) $176 - $186 97%
Medicare (plans) $176 - $279 97%
Aetna $176 - $275 97%
Affinity By Molina McR $184 - $195 101%
Cdphp $193 - $205 106%
Self-Pay $247 - $262 136%
Mvp Exchange $259 - $275 143%
Emblem Select Care (Exchange) $271 - $288 149%
Magnacare Standard $279 - $296 154%
Emblem Ghi/Hip Ppo/Cbp $287 - $305 158%
Todays Options $290 - $307 160%
Emblem Ghi/Hip Hmo/Epo/Pos $319 - $338 176%
Multiplan $327 - $347 180%
Oxford Exchange $346 191%
First Health $359 - $381 198%
Mvp $616 340%
Mvp Hmo/Ppo $727 401%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 42084 State Highway 28, Margaretville, NY 12455
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals