CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: Saint Joseph Regional Medical Center

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 92507
  • Insurance Median: $189
  • Cash Discount Price: $385
  • vs. Medicare Baseline: 2.48x Medicare
The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at Saint Joseph Regional Medical Center is $189. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $385. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 2.48x the Medicare baseline. Located in 5215 Holy Cross Pkwy, Mishawaka, IN.
Cash / Self-Pay
$385

Average discount available for prompt cash payment at this facility.

Insurance Median
$189

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: $385 (506%)
Insurance Median: $189 (248%)
Cash: $385 (506% of Medicare)
Ins. Median: $189 (248% 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 248% of the Medicare baseline (a markup of 148%). 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 $61 - $385 80%
Blue Cross Blue Shield $61 - $186 80%
Medicaid / KanCare $61 - $186 80%
UnitedHealthcare $61 - $378 80%
Medicare (plans) $74 - $75 97%
Meridian Complete $74 97%
Pace-Trinity Health $74 97%
County Coroner $77 101%
Provider Partners Health Plan Of Indiana $81 106%
Auxiant $111 - $492 146%
Physicians Health Plan Northern Indiana Health Insurance $111 - $223 146%
St Joseph County Hlth Dpt $111 146%
Caresource $115 151%
Siho Insurance Services $118 155%
Key Benefit Administrator $133 - $369 175%
Allied Benefit Systems $141 - $385 185%
Blue Benefit Administrators Of Massachusetts $148 194%
Blue Care Network $148 194%
Blue Distinction Transplant $148 194%
Blue Shield - Ca $148 194%
Blue Shield - Id (Regence) $148 194%
Blue Shield - Ny Highmark Northeastern $148 194%
Blue Shield - Ny Highmark Western $148 194%
Blue Shield - Pa (Highmark) $148 194%
Blue Shield - Wa (Regence) $148 194%
Hospice Of Marshall County $154 202%
Hospice Of St Joseph County $154 202%
Custom Design Benefits $159 209%
Plain Church Group $160 210%
Managed Health Services - Indiana $186 244%
Mdwise $186 244%
Notre Dame Athletic Association $326 428%
Wc Notre Dame $326 428%
Luminare Health (Detroit) $338 - $356 444%
Encore Health $351 - $369 461%
Ameriben $356 467%
Indiana Criminal Justice Inst $369 485%
Western & Southern Financial Group $369 485%
Geha $378 496%
Healthscope $378 496%
Student Insurance Cma $378 496%
Cigna $380 499%
Group Administrators $380 499%
Health Partners $380 499%
Mvp $380 499%
Prairie States $380 499%
Priority Health $380 499%
Professional Benefit Administrators $380 499%
Sagamore Health Network $380 - $439 499%
Sisco Benefits $380 499%
Unified Group Services $380 499%
Asr Health Benefits $385 506%
Christian Brother Services $385 506%
Employee Benefit Management $385 506%
Medical Mutual $385 506%
Meritain $385 506%
Preferred One $385 506%
Rural Carrier Health Benefit Plan $385 506%
Webtpa $385 506%
Goshen Preferred Network $457 - $510 600%
Christian Brothers Holy Cross $474 622%
Signature Care $474 622%
Bankers Life Casualty $593 779%
Bureau Of Disability $593 779%
Wc Align Network $593 779%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 5215 Holy Cross Pkwy, Mishawaka, IN 46545
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals