Speech therapy (language evaluation)
Facility: Providence Medical Center
Billing Code: 92507 (CPT)
- CPT Billing Code: 92507
- Insurance Median: $78
- Cash Discount Price: $72
- 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 |
|---|---|---|
| Aetna | $72 - $109 | 95% |
| Tricare | $73 | 96% |
| Midland Care Connection | $73 | 96% |
| UnitedHealthcare | $73 - $137 | 96% |
| Medicare (plans) | $73 | 96% |
| Cigna | $73 | 96% |
| Blue Cross Blue Shield | $73 - $172 | 96% |
| Kansas Superior Select | $77 | 101% |
| Medicaid / KanCare | $77 | 101% |
| Celtic | $77 - $117 | 101% |
| Healthy Blue | $77 - $78 | 101% |
| Corizon | $95 | 125% |
| Employer Direct Healthcare | $102 | 134% |
| Well Path Prison | $102 | 134% |
| Centurion | $109 | 143% |
| Naphcare | $113 | 148% |
| Oha Networks | $132 | 173% |
| Worker Compensation | $136 | 179% |
Consumer Guidance & Cost Commentary
For the speech therapy language evaluation service (CPT 92507) at Providence Medical Center in Kansas City, KS, the facility's cash median rate of $72.00 aligns closely with the state average, while the negotiated rates range from $72 to $172 depending on the insurance carrier. When comparing these figures to the Medicare benchmark of $76.15, the cash price is slightly lower than the federal baseline, which often serves as the most reliable indicator of true service cost. Patients with high-deductible plans may find paying the cash rate directly more advantageous than using insurance, as many commercial payers negotiate rates that exceed the cash price; for instance, Blue Cross Blue Shield plans can see negotiated amounts as high as $172, whereas self-pay patients pay $72. To maximize savings, it is recommended to verify if the specific insurance plan falls within the facility's network tiers, as in-network contracts can sometimes result in higher allowed amounts than out-of-network cash rates.
While the facility offers a median negotiated rate of $78.00 across its payer contracts, patients should be aware that balance billing is generally prohibited for emergency care and non-emergency services at in-network facilities under federal law, though unexpected charges can still occur for out-of-network ancillary services like certain lab tests. If a patient chooses to pay out-of-pocket, they should explicitly request a "self-pay" or "prompt-pay" discount before scheduling, as hospitals often provide fee reductions for upfront payments that bypass the administrative costs associated with insurance claims processing. Furthermore, since over 80% of hospital bills contain errors, patients should always request a full itemized statement before finalizing payment