Speech therapy (language evaluation)
Facility: Kansas Medical Center Llc
Billing Code: 92507 (CPT)
- CPT Billing Code: 92507
- Insurance Median: $74
- Cash Discount Price: $129
- vs. Medicare Baseline: 0.97x 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 | $58 | 76% |
| Tricare | $64 | 84% |
| Indian Health | $66 | 87% |
| Medadv_Wellcare | $73 | 96% |
| Ambetter / Centene | $73 | 96% |
| Humana | $73 | 96% |
| Blue Cross Blue Shield | $73 - $74 | 96% |
| Medicaid / KanCare | $77 | 101% |
| United | $85 | 112% |
| Wppa | $86 | 113% |
| Three_Rivers | $146 | 192% |
Consumer Guidance & Cost Commentary
For the speech therapy language evaluation service (CPT 92507) at Kansas Medical Center Llc in Andover, KS, the cash price of $129.00 is notably lower than the average negotiated rates paid by insurance plans, which range from $58 to $146 depending on the carrier. While the facility's cash rate is higher than the Medicare benchmark of $76.15, patients with high-deductible plans may find paying cash upfront more cost-effective than relying on insurance, as many commercial payers negotiate rates that exceed the cash price. It is important to note that the facility offers a proprietary ownership structure and has a facility rating of 2, but the primary financial consideration for consumers is the significant variance between the cash price and the negotiated amounts charged to different insurers.
To maximize savings, patients should proactively request "self-pay" or "prompt-pay" discounts before scheduling their visit, as these upfront payment incentives can reduce the final bill by 20% to 50%. Although the data does not provide a specific median negotiated rate for this facility, the wide spread of payer rates suggests that in-network coverage may not always result in the lowest possible cost. Consumers are advised to avoid accepting summary bills and instead demand a full itemized statement to verify that no unbundled codes or services not rendered have inflated the total. Furthermore, while the No Surprises Act protects against balance billing for out-of-network providers at in-network facilities, patients should still verify their specific plan details and deductible status to ensure they are aware of any potential out-of-pocket obligations before receiving care.