CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: City of Hope National Medical Center

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 92507
Insurance Median: $399
Cash Discount Price: $422
vs. Medicare Baseline: 5.24x Medicare

The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at City of Hope National Medical Center is $399. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $422. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 5.24x the Medicare baseline. Located in 1500 Duarte Rd, Duarte, CA.

Cash / Self-Pay

$422

Average discount available for prompt cash payment at this facility.

Insurance Median

$399

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: $422 (554%)

Insurance Median: $399 (524%)

Cash: $422 (554% of Medicare)

Ins. Median: $399 (524% 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 524% of the Medicare baseline (a markup of 424%). 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
Health Net	$24 - $771	32%
Heritage Provider Network	$30 - $461	39%
Cal Optima	$33 - $83	43%
Inland Empire	$51 - $526	67%
Prime Healthcare Keenan	$145 - $632	190%
Blue Cross Blue Shield	$192 - $461	252%
UnitedHealthcare	$215 - $796	282%
Blue Shield	$227 - $468	298%
Blue Shield Covca	$238	313%
Blue Shield Promise	$268 - $461	352%
Cencal	$307 - $526	403%
La Care Health	$307 - $526	403%
Kaiser	$345 - $592	453%
Aetna	$384 - $658	504%
Gold Coast	$384 - $658	504%
Molina	$384 - $855	504%
Cigna	$412 - $707	541%
Facey	$422 - $724	554%
Healthcare Partners	$445 - $763	584%
St. Joseph Heritage	$460 - $790	604%
Primecare Medical Network	$499 - $855	655%
First Health	$591 - $1,013	776%
Phcs Multiplan	$690 - $1,184	906%

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 $422.
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 City of Hope National Medical Center 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.