CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: Shriners Hospitals for Children Northern Calif

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 92507
Insurance Median: $92
Cash Discount Price: $433
vs. Medicare Baseline: 1.21x Medicare

The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at Shriners Hospitals for Children Northern Calif is $92. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $433. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 1.21x the Medicare baseline. Located in 2425 Stockton Boulevard, Sacramento, CA.

Cash / Self-Pay

$433

Average discount available for prompt cash payment at this facility.

Insurance Median

$92

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: $433 (569%)

Insurance Median: $92 (121%)

Cash: $433 (569% of Medicare)

Ins. Median: $92 (121% 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.

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	$73 - $80	96%
Ambetter / Centene	$73 - $92	96%
Molina Healthcare Of Ms	$73	96%
Northbay Healthcare	$80	105%
Amerihealth Caritas Nc	$84	110%
Amerihealth Caritas Sc	$84	110%
Caresource Of Oh	$84	110%
Sutter Medical Foundation	$88	116%
Health Net Of Ca	$92	121%
Kaiser Permanente	$100	131%
Sana Benefits	$103 - $112	135%
Blue Cross Blue Shield	$113 - $307	148%
Cigna	$130	171%
Providence Health Plan	$139	183%
UnitedHealthcare	$183	240%
Dignity Health	$233	306%

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 $433.
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 Shriners Hospitals for Children Northern Calif 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.