CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: Massac Memorial Hospital

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 92507
Insurance Median: $230
Cash Discount Price: $196
vs. Medicare Baseline: 3.02x Medicare

The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at Massac Memorial Hospital is $230. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $196. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 3.02x the Medicare baseline. Located in 28 Chick Street, Po Box 850, Metropolis, IL.

Cash / Self-Pay

$196

Average discount available for prompt cash payment at this facility.

Insurance Median

$230

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: $196 (257%)

Insurance Median: $230 (302%)

Cash: $196 (257% of Medicare)

Ins. Median: $230 (302% 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 302% of the Medicare baseline (a markup of 202%). 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
Blue Cross Blue Shield	$140 - $512	184%
Aetna	$148 - $512	194%
Health Alliance Mcare Adv	$148	194%
Humana	$148	194%
Health Alliance Exchange	$182	239%
Health Alliance-All Other Plans	$182	239%
Prime Health Services-All Plans	$182	239%
Healthlink Hmo	$205	269%
Healthlink Ppo-All Other Plans	$230	302%
Cigna	$231	303%
UnitedHealthcare	$235	309%
Multiplan-All Plans	$252	331%
Medicaid / KanCare	$512	672%
Molina Ky Mcaid	$512	672%

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 $196.
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 Massac 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.