Speech therapy (language evaluation)
Facility: Kansas City Orthopaedic Institute
Billing Code: 92507 (CPT)
- CPT Billing Code: 92507
- Insurance Median: $256
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 3.36x 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 336% of the Medicare baseline (a markup of 236%). 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 |
|---|---|---|
| Aetna | $98 | 129% |
| UnitedHealthcare | $98 | 129% |
| Cigna | $98 | 129% |
| Blue Cross Blue Shield | $256 | 336% |
Consumer Guidance & Cost Commentary
For the speech therapy language evaluation service (CPT 92507) at Kansas City Orthopaedic Institute in Leawood, KS, the facility's negotiated rate is $256.00, which aligns with the lowest and highest amounts reported for this code among the four payers listed. This negotiated rate is significantly higher than the Medicare benchmark of $76.15, reflecting a markup common in commercial contracts where administrative costs and claim processing inflate the baseline price. While the facility is an acute care hospital owned by physicians, the data indicates no specific cash or median paid values were reported for this service, meaning patients without insurance coverage should directly contact the billing department to confirm self-pay or prompt-pay discounts before scheduling.
Patients should be aware that commercial negotiated rates often exceed cash prices due to the administrative overhead required for insurance billing, which can range from 20% to 40% of the total cost. If you have a high-deductible plan, paying cash upfront might result in lower out-of-pocket costs compared to your insurance allowed amount, especially if the negotiated rate is high. Before finalizing any payment, it is crucial to request a formal itemized bill to verify that no unbundled codes or services not rendered are included, as over 80% of hospital bills contain errors. Additionally, if you encounter a balance bill from an out-of-network provider, you may be protected under the No Surprises Act, which prohibits providers from charging you the difference between their chargemaster rate and your insurance allowed amount for non-emergency services at in-network facilities.