CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: Hamilton Memorial Hospital

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 92507
  • Insurance Median: $144
  • Cash Discount Price: $166
  • vs. Medicare Baseline: 1.89x Medicare
The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at Hamilton Memorial Hospital is $144. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $166. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 1.89x the Medicare baseline. Located in 611 S Marshall Avenue, McLeansboro, IL.
Cash / Self-Pay
$166

Average discount available for prompt cash payment at this facility.

Insurance Median
$144

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: $166 (218%)
Insurance Median: $144 (189%)
Cash: $166 (218% of Medicare)
Ins. Median: $144 (189% 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.

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 $56 - $90 74%
Blue Cross Blue Shield $57 - $205 75%
Aetna $60 - $203 79%
Health Alliance $60 - $181 79%
Humana $60 - $90 79%
Medicare (plans) $60 - $90 79%
UnitedHealthcare $60 - $162 79%
Wellcare $60 - $90 79%
Alliance Coal $106 - $158 139%
Healthscope $106 - $158 139%
Wellfirst (Ssmhic) $106 - $158 139%
Hope Trust $113 - $169 148%
Cigna $119 - $177 156%
Hfn, Inc $121 - $203 159%
Healthlink $129 - $203 169%
Multiplan $129 - $192 169%
Siho $136 - $203 179%
Three Rivers Provider $136 - $203 179%
Healthsmart $144 - $214 189%
Stratose $144 - $214 189%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 611 S Marshall Avenue, McLeansboro, IL 62859
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals