CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: Decatur County Hospital

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 92507
  • Insurance Median: $202
  • Cash Discount Price: $202
  • vs. Medicare Baseline: 2.65x Medicare
The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at Decatur County Hospital is $202. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $202. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 2.65x the Medicare baseline. Located in 1405 Nw Church Street, Leon, IA.
Cash / Self-Pay
$202

Average discount available for prompt cash payment at this facility.

Insurance Median
$202

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: $202 (265%)
Insurance Median: $202 (265%)
Cash: $202 (265% of Medicare)
Ins. Median: $202 (265% 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 265% of the Medicare baseline (a markup of 165%). 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
Blue Cross Blue Shield $81 106%
Champva -All Plans $113 148%
Wellmark Hmo $129 169%
Everystep Hospice-All Plans $131 172%
Aetna $136 - $199 179%
Tricare $136 179%
Wellmark Ppo - All Other Plans $142 186%
UnitedHealthcare $151 - $214 198%
Benefit Admin System-All Plans $164 215%
Humana $184 242%
Meritain Health-All Plans $184 242%
Misc Commercial-All Plans $184 242%
All Savers-All Plans $189 248%
Allied Benefit System-All Plans $189 248%
American Family Ins Grp-All Plans $189 248%
Rural Carrier Benefit Plan-All Plans $194 255%
Christian Healthcare -All Plans $202 265%
Medica-All Other Plans $202 265%
Golden Rule-All Plans $214 281%
Ntca The Rural Broadband-All Plans $214 281%
Cigna $217 285%
Medical Mutual-All Plans $222 292%
Farm Bureau Financial-All Other Plans $227 298%
Farm Bureau Property And Ca $227 298%
Medi Share-All Plans $229 301%
Uhss-All Plans $229 301%
Health Partners-All Plans $232 305%
Lewermark-All Plans $239 314%
Mail Handlers Benefit-All Plans $247 324%
Midlands Choice-All Plans $247 324%
Priority Health-All Plans $252 331%
Iowa Total Care Mcaid-All Plans $257 337%
Amerigroup Mcaid-All Plans $265 348%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1405 Nw Church Street, Leon, IA 50144
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals