CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: Mercy Hospital Fort Smith

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 92507
  • Insurance Median: $176
  • Cash Discount Price: $213
  • vs. Medicare Baseline: 2.31x Medicare
The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at Mercy Hospital Fort Smith is $176. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $213. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 2.31x the Medicare baseline. Located in 7301 Rogers Ave, Fort Smith, AR.
Cash / Self-Pay
$213

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: $213 (280%)
Insurance Median: $176 (231%)
Cash: $213 (280% 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 - $68 29%
Summit Community Care Contracted [320368] $22 29%
Summit Community Care [20368] $22 29%
Arkansas Total Care Contracted [320039] $49 64%
Arkansas Total Care [20039] $49 64%
Mercy Interfacility [20513] $55 - $90 72%
Aetna $68 - $308 89%
Humana $68 - $329 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%
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%
Tricare $69 91%
UnitedHealthcare $69 - $186 91%
Valir Pace [20503] $69 91%
Wellfirst Health Mcr [20443] $69 91%
Cigna $72 - $168 95%
Usable Contracted [320409] $89 117%
Aither Health Contracted [320449] $100 - $164 131%
Edison Health Solutions Contracted [320502] $100 - $164 131%
Mercy Benefit Admin Contracted [320251] $100 - $247 131%
Health Choice Contracted [320166] $108 142%
90 Degree Benefits Contracted [320436] $125 - $206 164%
Show-Me Health Administrators Contracted [320483] $125 - $206 164%
Novasys Contracted [320285] $140 184%
Auxiant Contracted [320462] $150 - $267 197%
Ebms Contracted [320493] $150 - $247 197%
Healthlink Contracted [320179] $150 - $267 197%
Imagine 360 Contracted [320494] $150 - $247 197%
Municipal Health Plan Contracted [320271] $150 - $247 197%
Reflect Health Contracted [320492] $150 - $247 197%
Insurance System Inc Contracted [320465] $162 - $267 213%
Personify Health Contracted [320051] $162 - $267 213%
Preferred Health Plan Contracted [320522] $162 - $267 213%
Workers Comp [20426] $162 - $267 213%
United Medical Resources Contracted [320454] $186 244%
Ppo Plus Contracted [320310] $188 - $308 247%
First Health Contracted [320128] $193 - $318 253%
Employers Health Coalition Contracted [320116] $196 - $323 257%
Private Health Care Systems Contracted [320320] $200 - $329 263%
Private Health Care Systems [20320] $200 - $329 263%
Multiplan Contracted [320270] $212 - $349 278%
Multiplan [20270] $212 - $349 278%
Qual Choice Contracted [320324] $242 318%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 7301 Rogers Ave, Fort Smith, AR 72903
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals