CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: Adventist Health and Rideout

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 92507
Insurance Median: $518
Cash Discount Price: $157
vs. Medicare Baseline: 6.80x Medicare

The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at Adventist Health and Rideout is $518. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $157. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 6.80x the Medicare baseline. Located in 726 4Th St, Marysville, CA.

Cash / Self-Pay

$157

Average discount available for prompt cash payment at this facility.

Insurance Median

$518

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: $157 (206%)

Insurance Median: $518 (680%)

Cash: $157 (206% of Medicare)

Ins. Median: $518 (680% 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 680% of the Medicare baseline (a markup of 580%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Bc Mcal	$32	42%
Kaiser Mcr Adv	$80	105%
Tricare	$80	105%
UnitedHealthcare	$80 - $618	105%
Blue Cross Blue Shield	$81 - $548	106%
Kaiser Mcal	$81	106%
Medi-Cal	$81	106%
Ca Health And Wellness- All Plans	$100	131%
Celtic Mcaid-All Plans	$100	131%
Healthnet Mcal	$142	186%
Ah Employee Health Plan - All Plans	$144	189%
Aetna	$503	661%
Healthnet Comm-All Other Plans	$518	680%
Kaiser-All Other Plans	$541	710%
Blue Shield Uc Care Members	$570	749%
Cigna	$607	797%
First Health-All Plans	$623	818%
Phcs-All Plans	$627	823%
Interplan-All Plans	$641	842%
Blue Shield-All Other Plans	$676	888%
Multiplan-All Plans	$676	888%
Partnership Hp Mcal -All Plans	$1,175	1543%

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 $157.
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 Adventist Health and Rideout 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.