CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: Witham Health Services

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 92507
Insurance Median: $434
Cash Discount Price: $428
vs. Medicare Baseline: 5.70x Medicare

The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at Witham Health Services is $434. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $428. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 5.70x the Medicare baseline. Located in 2605 N Lebanon St, Lebanon, IN.

Cash / Self-Pay

$428

Average discount available for prompt cash payment at this facility.

Insurance Median

$434

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: $428 (562%)

Insurance Median: $434 (570%)

Cash: $428 (562% of Medicare)

Ins. Median: $434 (570% 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 570% of the Medicare baseline (a markup of 470%). 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	$74 - $846	97%
Mdwise Health In-All Plans	$74	97%
Caresource Mcr Adv	$75	98%
Aetna	$76 - $626	100%
Caresource Indiana Marketplace-All Other Plans	$140	184%
UnitedHealthcare	$173 - $660	227%
Phcs/Multiplan-All Plans	$184 - $770	242%
Sagamore-All Plans	$186 - $716	244%
Beech Street-All Plans	$190 - $796	250%
Encore-All Plans	$192 - $804	252%
Humana	$206 - $787	271%
Mhs Comml Exch-All Plans	$505 - $1,945	663%

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 $428.
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 Witham Health Services 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.