CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: Grandview Medical Center

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 92507
  • Insurance Median: $381
  • Cash Discount Price: $165
  • vs. Medicare Baseline: 5.00x Medicare
The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at Grandview Medical Center is $381. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $165. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 5.00x the Medicare baseline. Located in 3690 Grandview Parkway, Birmingham, AL.
Cash / Self-Pay
$165

Average discount available for prompt cash payment at this facility.

Insurance Median
$381

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$76.15

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $76.15 (100%)
Cash / Self-Pay: $165 (217%)
Insurance Median: $381 (500%)
Cash: $165 (217% of Medicare)
Ins. Median: $381 (500% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $76.15 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 500% of the Medicare baseline (a markup of 400%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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 $60 79%
Tricare $67 88%
Node Champva $70 92%
Veterans Eval Services $70 92%
Blue Advantage $71 93%
Humana $71 93%
Medicare (plans) $71 93%
UnitedHealthcare $71 - $387 93%
Victory Health $71 93%
Viva Health $71 - $191 93%
Cigna $72 - $171 95%
Hospice $72 95%
Node Devoted Health Mcr Adv $72 95%
Node Va $72 95%
Select Health $72 95%
Aetna $73 - $239 96%
Node Clover Health Mcr Adv $73 96%
Node Wellcare Mcr Adv $73 96%
Ambetter / Centene $108 142%
Node Us Dept Of Labor $112 147%
Self Pay $125 - $206 164%
Healthspring $126 165%
Bp Health Advocate $209 - $215 274%
Ag Administrators $292 - $301 383%
Alamed $292 - $301 383%
Choicecare $292 - $301 383%
Drummond $292 - $301 383%
American Employee Alliance $334 - $344 439%
Healthchoice $418 - $516 549%
Value Options $418 - $430 549%
First Health $501 - $673 658%
Multiplan $509 - $602 668%
Blue Bell Creameries $584 - $602 767%
Natl Comp Care $626 - $645 822%
Usa Ppo $626 - $645 822%
Coventry Work Comp Al $653 - $673 858%
Novanet $674 - $694 885%
Alabama Wc $710 - $731 932%
Cal-Med $710 - $731 932%
Corvel $710 - $731 932%
Associated Admin $752 - $774 988%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3690 Grandview Parkway, Birmingham, AL 35243
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals