CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: Elkhart General Hospital

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 92507
Insurance Median: $215
Cash Discount Price: $240
vs. Medicare Baseline: 2.82x Medicare

The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at Elkhart General Hospital is $215. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $240. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 2.82x the Medicare baseline. Located in 600 E Blvd, Elkhart, IN.

Cash / Self-Pay

$240

Average discount available for prompt cash payment at this facility.

Insurance Median

$215

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: $240 (315%)

Insurance Median: $215 (282%)

Cash: $240 (315% of Medicare)

Ins. Median: $215 (282% 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 282% of the Medicare baseline (a markup of 182%). 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
Devoted Healthcare	$30 - $114	39%
Blue Cross Blue Shield	$31 - $140	41%
Mclaren (Mi	$39	51%
UnitedHealthcare	$39 - $383	51%
Aetna	$67 - $386	88%
Humana	$72 - $399	95%
Pace	$72	95%
Cha	$89 - $445	117%
Immergrun	$89 - $456	117%
Mhs	$96 - $741	126%
Php	$96 - $399	126%
Cigna	$107 - $433	141%
Multiplan	$107 - $410	141%
Plain Church	$108 - $456	142%
Signature	$108 - $416	142%
Encore	$110 - $422	144%
Caresource	$115 - $741	151%
Heartland	$148 - $570	194%
Mdwise	$192 - $741	252%

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 $240.
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 Elkhart General 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.