Speech therapy (language evaluation)
Facility: Wesley Medical Center
Billing Code: 92507 (CPT)
- CPT Billing Code: 92507
- Insurance Median: $301
- Cash Discount Price: $1,257
- vs. Medicare Baseline: 3.95x 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 395% of the Medicare baseline (a markup of 295%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
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 | $62 | 81% |
| Triwest Health Alliance | $72 | 95% |
| Aetna | $73 - $700 | 96% |
| Humana | $73 | 96% |
| Coventry Health Care | $73 | 96% |
| Devoted Health | $73 | 96% |
| United | $74 - $882 | 97% |
| Ambetter / Centene | $77 - $353 | 101% |
| UnitedHealthcare | $77 | 101% |
| Medicaid / KanCare | $79 | 104% |
| Amerigroup | $80 | 105% |
| Health Partners Of Kansas | $98 - $980 | 129% |
| Wppa | $98 - $341 | 129% |
| Preferred Health Choices | $107 - $371 | 141% |
| Medical Associates Health Plan | $107 - $371 | 141% |
| Correct Care Solutions | $109 | 143% |
| Spirit Aerosystems | $180 - $628 | 236% |
| First Health | $260 - $904 | 341% |
| Triwest Healthcare Alliance | $367 - $1,275 | 482% |
| Multiplan | $395 - $1,765 | 519% |
| Usa Managed Care | $479 - $1,667 | 629% |
Consumer Guidance & Cost Commentary
For the speech therapy language evaluation (CPT 92507) at Wesley Medical Center in Wichita, KS, the cash price is $1,257.00, which matches the facility's cash median. This rate is significantly higher than the state average, which is approximately 4.0 times the Medicare benchmark of $76.15. While commercial insurance plans like Health Partners of Kansas and Multiplan have negotiated rates reaching up to $1,275 and $1,765 respectively, patients with high-deductible plans should consider that paying cash upfront might be cheaper if the insurance negotiated rate exceeds the cash price. It is important to verify the specific allowed amount for your plan, as some in-network rates can be substantially higher than others, and to ask the hospital directly about self-pay or prompt-pay discounts before scheduling services.
Patients should be aware that while the No Surprises Act protects against balance billing for out-of-network providers at in-network facilities, unexpected charges can still occur from ancillary services or if a provider is out-of-network. If you receive a bill, always request a full itemized statement to review every CPT code and unit cost, as over 80% of hospital bills contain errors such as double-billing or unbundled charges. Disputing these errors in writing with the billing supervisor is the most effective way to reduce medical debt, rather than accepting summary bills or settling verbally. Additionally, since commercial negotiated rates often include administrative overhead that inflates the baseline price, comparing your facility's rates directly to the Medicare benchmark provides a clearer picture of the true cost of care than looking at the hospital's gross chargemaster list.