CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: St Anthony Summit Medical Center

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 92507
Insurance Median: $168
Cash Discount Price: $112
vs. Medicare Baseline: 2.21x Medicare

The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at St Anthony Summit Medical Center is $168. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $112. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 2.21x the Medicare baseline. Located in 340 Peak One Drive, Frisco, CO.

Cash / Self-Pay

$112

Average discount available for prompt cash payment at this facility.

Insurance Median

$168

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: $112 (147%)

Insurance Median: $168 (221%)

Cash: $112 (147% of Medicare)

Ins. Median: $168 (221% 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 221% of the Medicare baseline (a markup of 121%). 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
Blue Cross Blue Shield	$59 - $716	77%
Centura Employee Plan	$72	95%
UnitedHealthcare	$75 - $257	98%
Aetna	$77 - $252	101%
Cigna	$77 - $241	101%
Devoted Health	$77	101%
Humana	$77	101%
Kaiser	$77	101%
Medicare (plans)	$77	101%
Denver Health	$83 - $168	109%
Peak Health	$113	148%
Direct To Employer	$119 - $168	156%
United Colorado Doctor'S Plan	$199	261%
Multiplan	$258	339%

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 $112.
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 St Anthony Summit 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.