CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: PAM Health Rehabilitation Hospital of Georgetown

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 92507
Insurance Median: $149
Cash Discount Price: $279
vs. Medicare Baseline: 1.96x Medicare

The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at PAM Health Rehabilitation Hospital of Georgetown is $149. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $279. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 1.96x the Medicare baseline. Located in 22303 Dupont Blvd, Georgetown, DE.

Cash / Self-Pay

$279

Average discount available for prompt cash payment at this facility.

Insurance Median

$149

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: $279 (366%)

Insurance Median: $149 (196%)

Cash: $279 (366% of Medicare)

Ins. Median: $149 (196% 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	$62 - $108	81%
Blue Cross Blue Shield	$74 - $80	97%
Pace (Milford Wellness Village)	$74	97%
Delaware First Health	$110	144%
Cigna	$120	158%
Americas Choice Provider Network	$139 - $252	183%
Quik Trip	$149 - $270	196%
Usa Managed Care Organization	$149 - $270	196%
Velocity Provider Ppo Network	$149 - $270	196%
Multiplan/Phcs	$159 - $288	209%
Prime Health Services	$169 - $306	222%
UnitedHealthcare	$176	231%

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 $279.
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 PAM Health Rehabilitation Hospital of Georgetown 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.