CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: Gundersen Palmer Lutheran Hospital and Clinics

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 92507
Insurance Median: $137
Cash Discount Price: $141
vs. Medicare Baseline: 1.80x Medicare

The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at Gundersen Palmer Lutheran Hospital and Clinics is $137. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $141. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 1.80x the Medicare baseline. Located in 112 Jefferson Street, West Union, IA.

Cash / Self-Pay

$141

Average discount available for prompt cash payment at this facility.

Insurance Median

$137

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: $141 (185%)

Insurance Median: $137 (180%)

Cash: $141 (185% of Medicare)

Ins. Median: $137 (180% 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
Amerigroup	$121 - $129	159%
Molina Health	$121	159%
Health Partners	$124 - $220	163%
UnitedHealthcare	$124 - $129	163%
Wellmark	$127 - $708	167%
Humana	$129	169%
Iowa Total Care	$129	169%
Managed Health Service	$129	169%
Ucare	$129 - $199	169%
Quartz	$136	179%
Alliance	$197 - $403	259%
Medical Associates	$199	261%
Aspirus Arise Health	$207	272%
Multiplan/Healtheos	$219 - $232	288%
Coventry Health Care	$237	311%
Midland Choice	$242	318%

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 $141.
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 Gundersen Palmer Lutheran Hospital and Clinics 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.