CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: Woodlawn Hospital

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 92507
Insurance Median: $283
Cash Discount Price: $290
vs. Medicare Baseline: 3.72x Medicare

The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at Woodlawn Hospital is $283. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $290. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 3.72x the Medicare baseline. Located in 1400 E 9Th St, Rochester, IN.

Cash / Self-Pay

$290

Average discount available for prompt cash payment at this facility.

Insurance Median

$283

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: $290 (381%)

Insurance Median: $283 (372%)

Cash: $290 (381% of Medicare)

Ins. Median: $283 (372% 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 372% of the Medicare baseline (a markup of 272%). 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
Aetna	$85 - $367	112%
Blue Cross Blue Shield	$85 - $386	112%
Caresource Mcaid Hip	$85	112%
Caresource Mcr Adv	$85	112%
Humana	$85 - $300	112%
Mdwise Mcaid Excel Hip	$85	112%
Mhs Exch Mrktplce-All Other Plans	$85	112%
Mhs Mcaid Hip	$85	112%
UnitedHealthcare	$85 - $386	112%
Mhs Mcr Adv	$87	114%
Caresource Exch - All Other Plans	$110	144%
Ambetter / Centene	$113	148%
Partners Direct Health-All Plans	$262	344%
Cigna	$276 - $328	362%
Parkview Health Plans-All Plans	$290	381%
Sagamore All Other Grps - All Other Plans	$324	425%
Encore Comm-All Plans	$328	431%
Phcs/Multiplan-All Plans	$359	471%
Community Health Alliance-All Plans	$367	482%
Caresource Mcaid Hww	$386	507%
Mhs Mcaid Hcc	$386	507%
Mhs Mcaid Hhw	$386	507%

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 $290.
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 Woodlawn 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.