CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: Natividad Medical Center

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 92507
Insurance Median: $437
Cash Discount Price: $616
vs. Medicare Baseline: 5.74x Medicare

The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at Natividad Medical Center is $437. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $616. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 5.74x the Medicare baseline. Located in 1441 Constitution Boulevard, Salinas, CA.

Cash / Self-Pay

$616

Average discount available for prompt cash payment at this facility.

Insurance Median

$437

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: $616 (809%)

Insurance Median: $437 (574%)

Cash: $616 (809% of Medicare)

Ins. Median: $437 (574% 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 574% of the Medicare baseline (a markup of 474%). 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
Aspire Mcr Adv - All Plans	$82	108%
Wgat Cedar - All Plans	$103	135%
Pacific Health Alliance - All Plans	$239 - $438	314%
Blue Cross Blue Shield	$281 - $514	369%
Blue Shield - All Plans	$283 - $518	372%
Aetna	$326 - $598	428%
UnitedHealthcare	$339 - $622	445%
Cigna	$370 - $677	486%
Medi-Cal	$435 - $797	571%
Medi-Cal Hmo - All Plans	$444 - $813	583%

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 $616.
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 Natividad 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.