CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: St Anthony Regional Hospital & Nursing Home

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 92507
  • Insurance Median: $129
  • Cash Discount Price: $314
  • vs. Medicare Baseline: 1.69x Medicare
The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at St Anthony Regional Hospital & Nursing Home is $129. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $314. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 1.69x the Medicare baseline. Located in 311 South Clark Street, Carroll, IA.
Cash / Self-Pay
$314

Average discount available for prompt cash payment at this facility.

Insurance Median
$129

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: $314 (412%)
Insurance Median: $129 (169%)
Cash: $314 (412% of Medicare)
Ins. Median: $129 (169% 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.

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
Aetna $113 - $283 148%
Humana $113 - $267 148%
Medica Mcr - All Plans $113 148%
UnitedHealthcare $113 - $253 148%
Va Ccn - All Plans $113 148%
Wellpoint Mcr Adv $113 148%
Ia Total Care Mcr $116 152%
Ia Total Care Mcaid $129 169%
Wellmark Hmo $129 169%
Wellpoint Mcaid - All Other Plans $129 169%
Molina Mcaid - All Plans $131 172%
Wellmark Ppo-All Other Plans $142 186%
Ia Total Care Comm - All Other Plans $147 193%
Midlands Choice - All Plans $295 387%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 311 South Clark Street, Carroll, IA 51401
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals