CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: Presence Mercy Medical Center

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 92507
Insurance Median: $78
Cash Discount Price: $77
vs. Medicare Baseline: 1.02x Medicare

The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at Presence Mercy Medical Center is $78. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $77. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 1.02x the Medicare baseline. Located in 1325 N Highland Avenue, Aurora, IL.

Cash / Self-Pay

$77

Average discount available for prompt cash payment at this facility.

Insurance Median

$78

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: $77 (101%)

Insurance Median: $78 (102%)

Cash: $77 (101% of Medicare)

Ins. Median: $78 (102% 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.

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
Blue Cross Blue Shield	$74 - $109	97%
Advocate Helath Partners	$78 - $85	102%
Aetna	$78 - $81	102%
Celtic (Wellcare)	$78	102%
Cigna	$78	102%
Clear Spring Health Of Illinois	$78	102%
Devoted Health	$78	102%
Essential Health Partners	$78 - $89	102%
Health Alliance Medical Plan	$78	102%
Humana	$78 - $85	102%
Longevity Health Plan Of Illinois	$78	102%
Medicare (plans)	$78	102%
Ravenswood Physicians Associates Ipa	$78	102%
Resurrection Physicians Provider Group Ipa	$78	102%
Self-Pay	$78	102%
Tricare	$78	102%
United Behavioral Health	$78	102%
UnitedHealthcare	$78 - $97	102%
Molina	$80 - $116	105%
Zing Health Provider Network	$80	105%
Meridian	$81	106%
Provider Partners Health Plan (Pphp)	$81	106%
Harmony Health Plan	$82	108%
Access Community Health Network	$93	122%
Clifton Health Systems	$120	158%
Ambetter / Centene	$126	165%
Imagine Health Network, Inc.	$149	196%
Community Partners Health Plan	$161	211%
Standard Eapg Logic - Contracts	$286	376%

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 $77.
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 Presence Mercy Medical Center 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.