CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: Riverside Community Hospital

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 92507
Insurance Median: $80
Cash Discount Price: $1,054
vs. Medicare Baseline: 1.05x Medicare

The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at Riverside Community Hospital is $80. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,054. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 1.05x the Medicare baseline. Located in 4445 Magnolia Avenue, Riverside, CA.

Cash / Self-Pay

$1,054

Average discount available for prompt cash payment at this facility.

Insurance Median

$80

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: $1,054 (1384%)

Insurance Median: $80 (105%)

Cash: $1,054 (1384% of Medicare)

Ins. Median: $80 (105% 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.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
La Care Health	$34	45%
Molina	$34	45%
Brand New Day	$38 - $80	50%
Inland Empire Health Plan	$49 - $136	64%
Bristol Hospice	$64	84%
Blue Shield	$74 - $265	97%
Health Net	$78 - $235	102%
Aetna	$79 - $190	104%
Alignment Health Plan	$80	105%
Blue Cross Blue Shield	$80	105%
Central Health Plan	$80	105%
Clever Care Of Golden State	$80	105%
Easy Choice Health Plan	$80	105%
Heritage Provider Network	$80 - $110	105%
Humana	$80	105%
Redlands Community Hospital	$80	105%
Riverside Medical Clinic	$80 - $96	105%
Riverside Physician	$80	105%
Scan Health Plan	$80	105%
Triwest Healthcare Alliance	$80	105%
UnitedHealthcare	$80	105%
Care1St Health Plan	$82	108%
United	$82 - $277	108%
Corvel Corporation	$93	122%
Healthsmart	$94 - $843	123%
Next	$94 - $843	123%
Medcare Partners	$158	207%
Bright Health	$417	548%
First Health	$464 - $948	609%
American Health System	$474	622%
Multiplan	$843 - $895	1107%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $1,054.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 92507.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Riverside Community Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 92507.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.