CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: Advocate Sherman Hospital

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 92507
Insurance Median: $155
Cash Discount Price: $134
vs. Medicare Baseline: 2.04x Medicare

The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at Advocate Sherman Hospital is $155. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $134. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 2.04x the Medicare baseline. Located in 1425 North Randall Road, Elgin, IL.

Cash / Self-Pay

$134

Average discount available for prompt cash payment at this facility.

Insurance Median

$155

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: $134 (176%)

Insurance Median: $155 (204%)

Cash: $134 (176% of Medicare)

Ins. Median: $155 (204% 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 204% of the Medicare baseline (a markup of 104%). 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
Advocate Employee	$65 - $162	85%
Cigna	$86 - $244	113%
Blue Cross Blue Shield	$94 - $216	123%
Ambetter / Centene	$112	147%
Molina	$112	147%
Oscar Health Hmo	$116	152%
Aetna	$123	162%
Private Healthcare Systems	$134 - $300	176%
Hstechnology	$148	194%
Multiplan	$148 - $333	194%
UnitedHealthcare	$212 - $268	278%

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 $134.
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 Advocate Sherman 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.