CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: Fishermen's Community Hospital

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 92507
Insurance Median: $356
Cash Discount Price: $409
vs. Medicare Baseline: 4.67x Medicare

The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at Fishermen's Community Hospital is $356. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $409. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 4.67x the Medicare baseline. Located in 3301 Overseas Hwy, Marathon, FL.

Cash / Self-Pay

$409

Average discount available for prompt cash payment at this facility.

Insurance Median

$356

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: $409 (537%)

Insurance Median: $356 (467%)

Cash: $409 (537% of Medicare)

Ins. Median: $356 (467% 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 467% of the Medicare baseline (a markup of 367%). 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	$105 - $629	138%
Leon Medical	$132	173%
Medica Health Plan	$132	173%
Medicare (plans)	$132 - $178	173%
UnitedHealthcare	$132 - $629	173%
Humana	$144	189%
Avmed	$145 - $521	190%
Aetna	$146 - $482	192%
Cigna	$151 - $503	198%
Amerigroup	$172	226%
Medicaid / KanCare	$172 - $189	226%
Wellcare	$181	238%
Sunshine State	$183	240%
Vista	$186	244%
Non Contracted	$231	303%
International	$409	537%
Amerihealth	$472	620%
Dimension Health Plan	$472 - $566	620%
Affordable	$566	743%
Phcs	$566	743%
Quality Health	$566	743%

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 $409.
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 Fishermen's Community 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.