Speech therapy (language evaluation)
Facility: Stormont Vail Hospital
Billing Code: 92507 (CPT)
- CPT Billing Code: 92507
- Insurance Median: $78
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 1.02x 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 | $74 - $120 | 97% |
| UnitedHealthcare | $78 | 102% |
| Ambetter / Centene | $78 | 102% |
Consumer Guidance & Cost Commentary
For this speech therapy language evaluation at Stormont Vail Hospital in Topeka, KS, the negotiated payment rates range from $74 to $120 across three major payers, with a median negotiated amount of $78.00. This negotiated rate is significantly higher than the Medicare benchmark of $76.15, reflecting the administrative costs and contract structures inherent in commercial insurance billing. While the facility's cash median is not listed, patients with high-deductible plans may find that paying the cash price directly is more cost-effective than relying on insurance, as the negotiated rate often exceeds the cash price. To maximize savings, patients should explicitly request "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can reduce the total bill by 20% to 50% by bypassing the costly claims processing cycle.
The facility is located in Topeka, KS, and operates as a voluntary non-profit acute care hospital. Although specific county or state average comparisons for this specific CPT code are not available in the current data, the transparent reporting of the Medicare benchmark provides a clear baseline for evaluating the facility's pricing markup. It is important to note that while the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, patients should still verify their specific plan details to avoid unexpected costs. If a patient receives an itemized bill, they are encouraged to request a full line-by-line audit to identify any unbundled codes or services not rendered, as over 80% of hospital bills contain errors that can be corrected through formal written disputes.