CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: Saint Agnes Medical Center

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 92507
  • Insurance Median: $259
  • Cash Discount Price: $222
  • vs. Medicare Baseline: 3.40x Medicare
The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at Saint Agnes Medical Center is $259. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $222. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 3.40x the Medicare baseline. Located in 1303 E Herndon Ave, Fresno, CA.
Cash / Self-Pay
$222

Average discount available for prompt cash payment at this facility.

Insurance Median
$259

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: $222 (292%)
Insurance Median: $259 (340%)
Cash: $222 (292% of Medicare)
Ins. Median: $259 (340% 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 340% of the Medicare baseline (a markup of 240%). 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
Correctcare Integrated Health $52 68%
Medi-Cal Healthnet $56 - $64 74%
Blue Cross Blue Shield $60 - $358 79%
Aetna $79 - $324 104%
Humana $79 - $83 104%
Medicare (plans) $79 - $83 104%
UnitedHealthcare $80 - $566 105%
Welbe Health $83 109%
Align Senior Care $92 121%
Kaiser Permanente $140 184%
Blue Shield - Ca $175 - $358 230%
Advantek Central Usd $181 238%
St Agnes Nicu Valley Childrens Hospital $222 292%
Healthnet $232 - $278 305%
Coventry $235 309%
Cba Network By Design $256 336%
Network Health $256 336%
Allegiance $263 345%
American Postal Workers Secondary $263 345%
Cigna $263 345%
Multiplan $286 376%
Phcs $286 376%
Interplan $307 403%
Meritain $307 403%
Trustmark Small Business Benefits $307 403%
Allied Benefit Systems $324 425%
Boon Chapman $324 425%
Hap $324 425%
Webtpa $324 425%
Blue Benefit Administrators Of Massachusetts $358 470%
Blue Care Network $358 470%
Blue Distinction Transplant $358 470%
Blue Shield - Id (Regence) $358 470%
Blue Shield - Ny Highmark Northeastern $358 470%
Blue Shield - Ny Highmark Western $358 470%
Blue Shield - Pa (Highmark) $358 470%
Blue Shield - Wa (Regence) $358 470%
Geha $558 733%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1303 E Herndon Ave, Fresno, CA 93720
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals