Speech therapy (language evaluation)
Facility: Ellinwood District Hospital
Billing Code: 92507 (CPT)
- CPT Billing Code: 92507
- Insurance Median: $88
- Cash Discount Price: $106
- vs. Medicare Baseline: 1.16x 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 |
|---|---|---|
| Humana | $88 | 116% |
| Aetna | $88 | 116% |
| Blue Cross Blue Shield | $88 | 116% |
| UnitedHealthcare | $88 | 116% |
| Cigna | $88 | 116% |
Consumer Guidance & Cost Commentary
For the speech therapy language evaluation service (CPT 92507) at Ellinwood District Hospital in Ellinwood, KS, the facility's negotiated rate of $88.00 aligns exactly with the state average for this procedure. While the hospital's cash-pay median is listed at $106.00, patients with high-deductible plans may find paying cash more expensive than using insurance, as the negotiated rate of $88.00 is lower than the cash price. It is important to note that commercial insurance rates often exceed cash prices due to administrative overhead and contract structures, meaning the $88.00 rate represents a fair market value rather than a discounted list price.
To ensure you are receiving the most accurate billing information, always request a full itemized bill before paying, as summary bills can obscure individual charges and potential errors. If you choose to pay out-of-pocket, ask the billing department about "prompt-pay" discounts, which can reduce the total cost by offering immediate liquidity incentives. Additionally, since this facility is a Critical Access Hospital with government ownership, verify your specific plan details to confirm that the $88.00 negotiated rate applies to your coverage and that you are not subject to unexpected balance billing for out-of-network ancillary services.