CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: Clay County Hospital

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 92507
  • Insurance Median: $267
  • Cash Discount Price: $420
  • vs. Medicare Baseline: 3.51x Medicare
The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at Clay County Hospital is $267. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $420. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 3.51x the Medicare baseline. Located in 911 Stacy Burk Dr, Flora, IL.
Cash / Self-Pay
$420

Average discount available for prompt cash payment at this facility.

Insurance Median
$267

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: $420 (552%)
Insurance Median: $267 (351%)
Cash: $420 (552% of Medicare)
Ins. Median: $267 (351% 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 351% of the Medicare baseline (a markup of 251%). 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
Aetna $74 - $332 97%
UnitedHealthcare $82 - $336 108%
Ambetter / Centene $113 148%
Medica(Wellfirst) $113 - $260 148%
Meridian $113 148%
Wellcare $113 148%
Blue Cross Blue Shield $121 - $308 159%
Healthlink $273 - $336 359%
Cigna $336 441%
Usa Mco $399 524%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 911 Stacy Burk Dr, Flora, IL 62839
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals