Speech therapy (language evaluation)
Facility: Ascension Via Christi Hospital Manhattan, Inc
Billing Code: 92507 (CPT)
- CPT Billing Code: 92507
- Insurance Median: $73
- Cash Discount Price: $96
- vs. Medicare Baseline: 0.96x 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 |
|---|---|---|
| Medicaid / KanCare | $66 - $80 | 87% |
| Humana | $72 | 95% |
| Va | $72 | 95% |
| Medicare (plans) | $72 - $73 | 95% |
| UnitedHealthcare | $73 - $200 | 96% |
| Aetna | $80 | 105% |
| Blue Cross Blue Shield | $84 - $89 | 110% |
| Providrs Care | $93 | 122% |
| Smarthealth | $100 | 131% |
| Ambetter / Centene | $122 | 160% |
Consumer Guidance & Cost Commentary
For the CPT code 92507, representing speech therapy (language evaluation), the facility's cash median rate is $96.00, which is significantly higher than the state average of $76.15. While commercial insurance plans like Medicaid/KanCare and Humana negotiate rates between $66 and $80, these negotiated amounts often exceed the cash price, meaning patients with high-deductible plans might save money by paying the cash rate directly. It is important to note that the facility's cash rate is also higher than the median negotiated rate of $73.00, suggesting that for some payers, the contractual agreement results in a higher out-of-pocket cost compared to self-pay.
To maximize savings, patients should verify if the hospital offers "self-pay" or "prompt-pay" discounts, which can reduce the bill by 20% to 50% when paid upfront, bypassing administrative fees associated with insurance claims. Although the facility is an in-network provider for most major payers, patients must confirm their specific deductible status before scheduling, as paying the negotiated rate without meeting the deductible can result in higher costs than paying cash. Additionally, while the No Surprises Act protects against balance billing for out-of-network services at in-network facilities, patients should always request a detailed, itemized bill to ensure no errors or unbundled charges are included before finalizing payment.