CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: Decatur Memorial Hospital

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 92507
  • Insurance Median: $282
  • Cash Discount Price: $484
  • vs. Medicare Baseline: 3.70x Medicare
The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at Decatur Memorial Hospital is $282. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $484. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 3.70x the Medicare baseline. Located in 2300 North Edward Street, Decatur, IL.
Cash / Self-Pay
$484

Average discount available for prompt cash payment at this facility.

Insurance Median
$282

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: $484 (636%)
Insurance Median: $282 (370%)
Cash: $484 (636% of Medicare)
Ins. Median: $282 (370% 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 370% of the Medicare baseline (a markup of 270%). 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
Medicaid / KanCare $9 - $292 12%
Blue Cross Blue Shield $66 - $497 87%
Illinois Workers Compensation $66 - $264 87%
Aetna $71 - $333 93%
Coventry $71 - $298 93%
Health Alliance $71 - $330 93%
Humana $71 - $323 93%
Medicare (plans) $71 - $72 93%
UnitedHealthcare $71 - $497 93%
Veterans Administration $71 - $72 93%
Wellcare $71 93%
Tricare $73 - $74 96%
Caterpillar $91 120%
Mennonite Churches $202 - $214 265%
Plain Church Medical Group $212 - $224 278%
Health Alliance Mh Employee Plan $216 - $229 284%
Cigna $219 - $232 288%
Hfn $235 - $373 309%
Commercial Workers Compensation $238 - $251 313%
6 Degrees Health $282 - $298 370%
Hopetrust $282 - $298 370%
Hst $282 - $298 370%
Phcs Savility $306 - $323 402%
Phcs Multiplan Ppo $320 - $338 420%
Healthlink $322 - $341 423%
Corvel $338 - $358 444%
Consociate $348 - $368 457%
Liability $470 - $497 617%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2300 North Edward Street, Decatur, IL 62526
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals