Speech therapy (language evaluation)
Facility: Saint John Hospital
Billing Code: 92507 (CPT)
- CPT Billing Code: 92507
- Insurance Median: $77
- Cash Discount Price: $72
- vs. Medicare Baseline: 1.01x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
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 | $37 - $78 | 49% |
| Tricare | $73 | 96% |
| Aetna | $73 - $109 | 96% |
| Medicare (plans) | $73 | 96% |
| Midland Care Connection | $73 | 96% |
| UnitedHealthcare | $73 - $102 | 96% |
| Cigna | $73 | 96% |
| Kansas Superior Select | $74 | 97% |
| Celtic | $77 - $185 | 101% |
| Medicaid / KanCare | $77 | 101% |
| Healthy Blue | $77 - $78 | 101% |
| Well Path | $102 | 134% |
| Employer Direct Healthcare | $102 | 134% |
| Corizon | $102 | 134% |
| Centurion | $109 | 143% |
| Naphcare | $113 | 148% |
| Oha Networks | $132 | 173% |
| Worker Compensation | $136 | 179% |
Consumer Guidance & Cost Commentary
For this speech therapy evaluation at Saint John Hospital in Leavenworth, KS, the cash price of $72.00 is notably lower than the facility's negotiated rates with major payers, which range from $73.00 to $185.00 depending on the insurance plan. While the hospital's cash rate aligns closely with the state average of $72.00, patients should be aware that commercial insurance contracts often result in higher out-of-pocket costs due to administrative fees and contract structures. If you have a high-deductible plan, paying the cash price upfront may be more cost-effective than relying on insurance, especially since the negotiated rates for many carriers exceed the cash amount. To secure the lowest possible price, we recommend asking the billing department about "self-pay" or "prompt-pay" discounts before scheduling your visit, as these upfront payment incentives can further reduce the final bill.
The facility's cash rate is also consistent with the Medicare benchmark of $76.15, which serves as a reliable baseline for evaluating fair pricing in this region. Although the hospital's gross charge is $529.00, the actual amount paid by insurers averages around $77.00, indicating that the negotiated rates are already significantly reduced from the list price. Because the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, you should not expect to be billed for the difference between the hospital's full charge and your insurance payment. If you receive an itemized bill, review it carefully to ensure no unbundled codes or services not rendered are included, and do not pay immediately if you suspect errors; instead, request a formal written audit