Speech therapy (language evaluation)
Facility: Pratt Regional Medical Center
Billing Code: 92507 (CPT)
- CPT Billing Code: 92507
- Insurance Median: $118
- Cash Discount Price: $112
- vs. Medicare Baseline: 1.55x 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 |
|---|---|---|
| Celtic Insurance Company | $73 | 96% |
| Healthy Blue | $75 | 98% |
| UnitedHealthcare | $80 - $205 | 105% |
| Christian Health Aid | $89 - $151 | 117% |
| Health Partners Of Kansas | $100 - $171 | 131% |
| Aetna | $106 - $181 | 139% |
| Choicecare | $118 - $201 | 155% |
Consumer Guidance & Cost Commentary
For this speech therapy evaluation at Pratt Regional Medical Center, the cash price of $112 is significantly lower than the facility's negotiated rates, which range from $73 to $205 depending on the insurance carrier. While the cash rate is higher than the Medicare benchmark of $76.15, it remains well below the gross charge of $160 and the median negotiated amount of $118. Patients with high-deductible plans may find paying the cash price directly more cost-effective than relying on insurance, as the negotiated rates for in-network payers like UnitedHealthcare and Aetna often exceed the cash amount. It is important to note that the cash price does not reflect the state or county average, but rather represents the direct cost to a self-pay patient, whereas insurance members are subject to the specific contract limits of their plan.
Before scheduling, patients should verify their specific plan's allowed amount and check for potential "self-pay" or "prompt-pay" discounts, which can further reduce the final balance. Although the facility is in-network for the listed payers, the wide variation in negotiated rates—from a low of $73 with Celtic Insurance Company to a high of $201 with Choicecare—highlights that being in-network does not guarantee the lowest possible price. To ensure you are receiving the most accurate pricing, always request an itemized bill before payment to confirm that no unbundled codes or services not rendered have inflated the total. If you receive a summary bill, insist on a detailed breakdown of CPT codes to identify any errors or double-charges that could be disputed.