CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: Marinhealth Medical Center

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 92507
Insurance Median: $490
Cash Discount Price: $642
vs. Medicare Baseline: 6.43x Medicare

The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at Marinhealth Medical Center is $490. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $642. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 6.43x the Medicare baseline. Located in 250 Bon Air Road, Greenbrae, CA.

Cash / Self-Pay

$642

Average discount available for prompt cash payment at this facility.

Insurance Median

$490

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: $642 (843%)

Insurance Median: $490 (643%)

Cash: $642 (843% of Medicare)

Ins. Median: $490 (643% 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 643% of the Medicare baseline (a markup of 543%). 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
Aetna	$93 - $190	122%
Brown And Tolan	$93	122%
Healthnet Tailored Network	$93	122%
Kaiser	$93	122%
Marin Cancer Care	$93	122%
Blue Cross Blue Shield	$126 - $160	165%
Ca Prison Health Care Services	$149	196%
Healthnet Enhancedcare	$243	319%
Provider Network Of America	$444	583%
Canopy	$537	705%
Canopy Hill Physicians	$537	705%
Blue Shield Cpic/Epo	$554	728%
Providers Network Of America	$588	772%
Blue Shield Hmo/Ppo	$615	808%
Hills Blue Shield Hmo/Ppo	$615	808%
Healthnet Hmo/Ppo	$623	818%
Healthnet Hmo/Ppo Hill Physicians	$623	818%
Blue Shield Aco	$638	838%
Cigna	$662	869%
UnitedHealthcare	$2,330	3060%

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 $642.
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 Marinhealth 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.