CMS Price Transparency Data
Speech therapy (language evaluation)
Facility: Mercy Hospital Northwest Arkansas
Billing Code: 92507 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 92507
- Insurance Median: $176
- Cash Discount Price: $226
- vs. Medicare Baseline: 2.31x Medicare
The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at Mercy Hospital Northwest Arkansas is $176. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $226. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 2.31x the Medicare baseline. Located in 2710 South Rife Medical Lane, Rogers, AR.
Cash / Self-Pay
$226
Average discount available for prompt cash payment at this facility.
Insurance Median
$176
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: $226 (297%)
Insurance Median: $176 (231%)
Cash: $226 (297% of Medicare)
Ins. Median: $176 (231% 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 231% of the Medicare baseline (a markup of 131%). 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 |
|---|---|---|
| Arkansas Department Of Health [20036] | $22 | 29% |
| Medicaid / KanCare | $22 - $98 | 29% |
| Summit Community Care Contracted [320368] | $22 | 29% |
| Summit Community Care [20368] | $22 | 29% |
| Mercy Interfacility [20513] | $40 - $86 | 53% |
| Arkansas Total Care Contracted [320039] | $49 | 64% |
| Arkansas Total Care [20039] | $49 | 64% |
| Aetna | $68 - $356 | 89% |
| Humana | $68 - $379 | 89% |
| American Health Advantage Of Mo Mcr [20264] | $69 | 91% |
| Blue Cross Blue Shield | $69 - $89 | 91% |
| Cherokee Nation Health Serv Contracted [320066] | $69 | 91% |
| Cigna | $69 - $164 | 91% |
| Cross Timbers Hospice [20098] | $69 | 91% |
| Dept Of Veteran Affairs Contracted [320106] | $69 | 91% |
| Elara Caring Aspire Hospice Contracted [320433] | $69 | 91% |
| Elara Caring Aspire Hospice [20433] | $69 | 91% |
| Globalhealth Contracted [320145] | $69 | 91% |
| Halo Hcr Inc Hospice Contracted [320432] | $69 | 91% |
| Halo Hcr Inc Hospice [20432] | $69 | 91% |
| Independent Health [20197] | $69 | 91% |
| Jordan Valley Senior Care Pace [20515] | $69 | 91% |
| Kindful Hospice Contracted [320434] | $69 | 91% |
| Kindful Hospice [20434] | $69 | 91% |
| Medical Associates Health [20444] | $69 | 91% |
| Medicare (plans) | $69 - $72 | 91% |
| Mercy Hospice Okc [20252] | $69 | 91% |
| Pace Of The Ozarks [20518] | $69 | 91% |
| Provider Partners Health Plans Contracted [320450] | $69 | 91% |
| Qual Choice Contracted [320325] | $69 | 91% |
| Spina Bifida Hlthcare Benefit [20506] | $69 | 91% |
| Tribute Health Plan Mcr [20338] | $69 | 91% |
| UnitedHealthcare | $69 - $157 | 91% |
| Valir Pace [20503] | $69 | 91% |
| Wellfirst Health Mcr [20443] | $69 | 91% |
| Tricare | $74 | 97% |
| St Johns Mercy Rehab Llc Contracted [320359] | $77 | 101% |
| St Johns Mercy Rehab Llc [20359] | $77 | 101% |
| Aither Health Contracted [320449] | $88 - $190 | 116% |
| Edison Health Solutions Contracted [320502] | $88 - $190 | 116% |
| Mercy Benefit Admin Contracted [320251] | $88 - $284 | 116% |
| Yuzu Health Contracted [320521] | $88 - $190 | 116% |
| Usable Contracted [320409] | $89 | 117% |
| Ambetter / Centene | $98 | 129% |
| Home State Health Plan Contracted [320187] | $98 | 129% |
| Novasys Contracted [320285] | $98 - $141 | 129% |
| Health Choice Contracted [320166] | $108 | 142% |
| 90 Degree Benefits Contracted [320436] | $110 - $237 | 144% |
| Show-Me Health Administrators Contracted [320483] | $110 - $237 | 144% |
| Auxiant Contracted [320462] | $133 - $308 | 175% |
| Ebms Contracted [320493] | $133 - $284 | 175% |
| Healthlink Contracted [320179] | $133 - $308 | 175% |
| Imagine 360 Contracted [320494] | $133 - $284 | 175% |
| Municipal Health Plan Contracted [320271] | $133 - $284 | 175% |
| Reflect Health Contracted [320492] | $133 - $284 | 175% |
| Benefit Management Contracted [320052] | $144 - $308 | 189% |
| Federal Medical Center Contracted [320127] | $144 - $308 | 189% |
| Insurance System Inc Contracted [320465] | $144 - $308 | 189% |
| Personify Health Contracted [320051] | $144 - $308 | 189% |
| Point C Contracted [320238] | $144 - $308 | 189% |
| Preferred Health Plan Contracted [320522] | $144 - $308 | 189% |
| Tri State Healthcare Coalition Contracted [320379] | $144 - $308 | 189% |
| Workers Comp [20426] | $144 - $308 | 189% |
| United Medical Resources Contracted [320454] | $157 | 206% |
| Private Health Care Systems Contracted [320320] | $161 - $346 | 211% |
| Private Health Care Systems [20320] | $161 - $346 | 211% |
| Ppo Plus Contracted [320310] | $166 - $356 | 218% |
| First Health Contracted [320128] | $171 - $366 | 225% |
| Employers Health Coalition Contracted [320116] | $173 - $372 | 227% |
| Healthscope Contracted [320182] | $177 - $379 | 232% |
| Multiplan Contracted [320270] | $188 - $403 | 247% |
| Multiplan [20270] | $188 - $403 | 247% |
| Qual Choice Contracted [320324] | $242 | 318% |