CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: Mercyone Oelwein Medical Center

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 92507
  • Insurance Median: $347
  • Cash Discount Price: $246
  • vs. Medicare Baseline: 4.56x Medicare
The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at Mercyone Oelwein Medical Center is $347. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $246. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 4.56x the Medicare baseline. Located in 201 Eighth Avenue Se, Oelwein, IA.
Cash / Self-Pay
$246

Average discount available for prompt cash payment at this facility.

Insurance Median
$347

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: $246 (323%)
Insurance Median: $347 (456%)
Cash: $246 (323% of Medicare)
Ins. Median: $347 (456% 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 456% of the Medicare baseline (a markup of 356%). 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
Medicare (plans) $144 - $161 189%
Iowa Total Care $147 193%
Medicaid / KanCare $149 196%
Blue Cross Blue Shield $153 201%
UnitedHealthcare $164 - $326 215%
Aetna $178 - $347 234%
Amish Hospital Aid $206 271%
Centivo $232 305%
Ambetter / Centene $260 341%
Health Choices $278 365%
Medical Associates $278 365%
Claimdoc $312 410%
Nova $312 410%
Geha $326 428%
1199 National Benefit Fund $347 456%
Allied Benefit Systems $347 456%
Asr Health Benefits $347 456%
Christian Brother Services $347 456%
Coventry $347 456%
First Health $347 456%
Lucent Health $347 456%
Luminare Health $347 456%
Medical Mutual $347 456%
Meritain $347 456%
Trustmark Small Business Benefits $347 456%
Webtpa $347 456%
Health Partners $364 478%
Multiplan $367 482%
Auxiant $370 486%
Cigna $370 486%
Medica $370 486%
Midlands $370 486%
Midlands Choice $370 486%
Crime Victim Assistance $378 496%
Iowa Dept Of Public Health $378 496%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 201 Eighth Avenue Se, Oelwein, IA 50662
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals