CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: Memorial Hospital

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 92507
Insurance Median: $324
Cash Discount Price: $288
vs. Medicare Baseline: 4.25x Medicare

The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at Memorial Hospital is $324. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $288. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 4.25x the Medicare baseline. Located in 1454 N County Road 2050 E, Carthage, IL.

Cash / Self-Pay

$288

Average discount available for prompt cash payment at this facility.

Insurance Median

$324

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: $288 (378%)

Insurance Median: $324 (425%)

Cash: $288 (378% of Medicare)

Ins. Median: $324 (425% 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 425% of the Medicare baseline (a markup of 325%). 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
Aetna	$101 - $360	133%
Blue Cross Blue Shield	$101 - $360	133%
Cigna	$101 - $360	133%
Health Alliance	$101 - $360	133%
Humana	$101 - $360	133%
Meridian	$101 - $360	133%
Molina	$101 - $360	133%
UnitedHealthcare	$101 - $360	133%
Consociate	$306 - $360	402%
Healthlink	$306 - $360	402%
Private Healthcare Systems	$306	402%
Integrated Health Plan	$317	416%
First Health Network	$320 - $360	420%
Health Dynamics	$324	425%
Health Payors Org	$324	425%
Iowa Health Solutions	$324	425%
Multiplan	$324	425%
Preferred Plan Inc	$324	425%
Three Rivers Provider Network	$324	425%
Health First Network	$328	431%
Pponext	$328	431%
Corvel	$342	449%

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 $288.
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 Memorial 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.