CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: Loma Linda University Children's Hospital

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 92507
Insurance Median: $419
Cash Discount Price: $289
vs. Medicare Baseline: 5.50x Medicare

The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at Loma Linda University Children's Hospital is $419. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $289. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 5.50x the Medicare baseline. Located in 11234 Anderson Street Suite A, Loma Linda, CA.

Cash / Self-Pay

$289

Average discount available for prompt cash payment at this facility.

Insurance Median

$419

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: $289 (380%)

Insurance Median: $419 (550%)

Cash: $289 (380% of Medicare)

Ins. Median: $419 (550% 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 550% of the Medicare baseline (a markup of 450%). 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
Inland Empire Health Plan (Iehp)	$50	66%
Kaiser Foundation Hospitals	$56 - $549	74%
Adventist Health	$103 - $337	135%
Lluh Dept Of Risk Management	$123 - $198	162%
Epic Health Plan	$205 - $329	269%
UnitedHealthcare	$206 - $417	271%
Blue Shield Of California	$279 - $421	366%
Alpha Care Medical Group	$282 - $700	370%
Global Benefits Group	$308 - $494	404%
Temecula Valley Physicians Medical Group	$308 - $494	404%
Trivalley Medical Group	$308 - $494	404%
Cigna	$328 - $609	431%
Networks By Design	$333 - $535	437%
Aetna	$336 - $540	441%
Molina Healthcare Of Ca	$359 - $576	471%
Multiplan	$410 - $658	538%
Dignity Health	$436 - $700	573%
Galaxy Health	$436 - $700	573%
Prime Health Services	$436 - $700	573%
Vantage Medical Group	$436 - $700	573%
Blue Cross Blue Shield	$457	600%

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 $289.
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 Loma Linda University Children's Hospital 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.