CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: Medstar Health Physical Therapy

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 92507
  • Insurance Median: $179
  • Cash Discount Price: $177
  • vs. Medicare Baseline: 2.35x Medicare
The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at Medstar Health Physical Therapy is $179. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $177. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 2.35x the Medicare baseline. Located in 102 Irving St Nw, Washington, DC.
Cash / Self-Pay
$177

Average discount available for prompt cash payment at this facility.

Insurance Median
$179

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: $177 (232%)
Insurance Median: $179 (235%)
Cash: $177 (232% of Medicare)
Ins. Median: $179 (235% 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 235% of the Medicare baseline (a markup of 135%). 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
Carefirst Advantage Inc $83 109%
Tricare $84 110%
UnitedHealthcare $84 - $239 110%
Aetna $85 - $192 112%
Health Care Service Corporation $87 114%
Humana $87 114%
Kaiser Permanente $87 - $531 114%
Medstar Family Choice Inc $96 126%
Carefirst Blue Choice Inc $132 - $176 173%
Jhhc $175 - $179 230%
Pfc $175 - $179 230%
Kaiser $211 - $215 277%
Cigna $229 - $234 301%
First Health $229 - $234 301%
Private Healthcare Systems (Phcs) $229 - $234 301%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 102 Irving St Nw, Washington, DC 20010
  • CMS Rating: No CMS Rating
  • Ownership Type: N/A
  • Hospital Type: PART A PROVIDER - HOSPITAL