CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: Adventist Health Twin Cities

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 92507
  • Insurance Median: $474
  • Cash Discount Price: $46
  • vs. Medicare Baseline: 6.22x Medicare
The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at Adventist Health Twin Cities is $474. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $46. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 6.22x the Medicare baseline. Located in 1100 Las Tablas Rd, Templeton, CA.
Cash / Self-Pay
$46

Average discount available for prompt cash payment at this facility.

Insurance Median
$474

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: $46 (60%)
Insurance Median: $474 (622%)
Cash: $46 (60% of Medicare)
Ins. Median: $474 (622% 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 622% of the Medicare baseline (a markup of 522%). 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
Aetna $81 - $474 106%
Cencal Mcr Adv - All Other Plans $81 106%
Tricare $81 106%
UnitedHealthcare $81 - $431 106%
Cfmg-Ca Forensic Med Grp Op/Profee Only-All Plans $106 139%
Ah Employee Health Plan - All Plans $146 192%
Hpn-Heritage Prov Ntwrk-All Plans $172 - $305 226%
Blue Shield Epn $244 320%
Chn-Community Hlth Ntwrk-All Plans $279 - $494 366%
Blue Shield Hmo/Pos $280 368%
Nbd-Ntwrks By Design Exlus-All Other Plans $293 - $519 385%
Nbd-Ntwrks By Design Non-Exlus $293 - $519 385%
Blue Shield Epo/Ppo - All Other Plans $329 432%
Pacific Health Alliance-All Plans $456 - $808 599%
Medi-Cal $507 - $898 666%
Cencal Mcal $578 - $1,024 759%
Blue Shield Promise Mcal $609 - $1,079 800%
Ccah-Centrl Ca Allince Mcal-All Plans $659 - $1,167 865%
Coalinga-All Plans $659 - $1,167 865%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1100 Las Tablas Rd, Templeton, CA 93465
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals