Speech therapy (language evaluation)
Facility: Lmh
Billing Code: 92507 (CPT)
- CPT Billing Code: 92507
- Insurance Median: $76
- Cash Discount Price: $55
- vs. Medicare Baseline: 1.00x 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 |
|---|---|---|
| UnitedHealthcare | $66 - $185 | 87% |
| Blue Cross Blue Shield | $66 - $142 | 87% |
| Aetna | $69 - $182 | 91% |
| Haskell Indian Health Services | $73 | 96% |
| Humana | $73 | 96% |
| Cigna | $73 - $147 | 96% |
| Medicare (plans) | $73 | 96% |
| Allwell | $74 | 97% |
| Ambetter / Centene | $113 | 148% |
| Non Contracted | $176 | 231% |
| First Health | $204 | 268% |
Consumer Guidance & Cost Commentary
For this speech therapy evaluation at Lmh in Lawrence, KS, the facility's cash price of $55.00 is notably lower than the state average for this service, which sits at $76.15. While commercial insurers like UnitedHealthcare and Aetna have negotiated rates ranging from $66 to $185, these amounts often exceed the cash price due to administrative overhead and contract structures. Patients with high-deductible plans may find it financially advantageous to pay the $55.00 cash rate directly, as this avoids the higher negotiated fees that insurance carriers typically charge. It is important to verify the specific allowed amount with your insurer before scheduling, as in-network rates vary significantly even within the same facility.
To minimize costs, patients should proactively ask the hospital about "self-pay" or "prompt-pay" discounts, which can reduce the bill by 20% to 50% if paid in full upfront. Since the facility is a government-owned acute care hospital, these discounts may be available to bypass the standard insurance billing cycle and its associated administrative fees. Additionally, because the facility is in-network, the No Surprises Act protects patients from balance billing for out-of-network services at this location, though it is still wise to request an itemized bill to ensure no unbundled charges or services not rendered are included. Comparing the facility's cash rate against the state average confirms that paying out-of-pocket can be a more economical strategy than relying on standard insurance processing for this specific procedure.