CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: Sarasota Memorial Hospital

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 92507
Insurance Median: $199
Cash Discount Price: $152
vs. Medicare Baseline: 2.61x Medicare

The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at Sarasota Memorial Hospital is $199. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $152. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 2.61x the Medicare baseline. Located in 1700 S Tamiami Trl, Sarasota, FL.

Cash / Self-Pay

$152

Average discount available for prompt cash payment at this facility.

Insurance Median

$199

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: $152 (200%)

Insurance Median: $199 (261%)

Cash: $152 (200% of Medicare)

Ins. Median: $199 (261% 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 261% of the Medicare baseline (a markup of 161%). 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	$72 - $124	95%
Aetna	$76 - $313	100%
UnitedHealthcare	$76 - $294	100%
Simply Freedom Optimum	$77	101%
Wellcare	$77	101%
Wellcare Oncology	$79	104%
Florida Community Care	$81 - $208	106%
Simply Freedom Optimum Oncology	$81	106%
Florida Community Care Oncology	$92	121%
Oscar Oncology	$126	165%
Simply Healthcare	$189 - $198	248%
Sunshine State	$198	260%
Ambetter / Centene	$199	261%
Molina	$204	268%
Amerihealth Caritas	$208	273%
Community Care Plan	$208	273%
Careworks	$249	327%
Enlyte	$249	327%
Avmed	$269 - $285	353%
Usa Managed Care	$294 - $313	386%
First Health	$305 - $325	401%

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 $152.
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 Sarasota Memorial 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.