Speech therapy (language evaluation)
Facility: Lane County Hospital
Billing Code: 92507 (CPT)
- CPT Billing Code: 92507
- Insurance Median: $115
- Cash Discount Price: $115
- vs. Medicare Baseline: 1.51x 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 | $104 - $109 | 137% |
| UnitedHealthcare | $104 - $115 | 137% |
| Healthy Blue Mcr Adv - All Other Plans | $115 | 151% |
| Medicaid / KanCare | $115 - $126 | 151% |
| Healthy Blue Mcaid | $115 | 151% |
| Wppa Providers-All Plans | $172 | 226% |
Consumer Guidance & Cost Commentary
For the CPT code 92507, representing a speech therapy language evaluation, the facility's cash and negotiated rates are both $115.00, which matches the median paid amount. This rate is 50% higher than the Medicare benchmark of $76.15, indicating a markup typical of commercial pricing structures. While the facility is a Critical Access Hospital in Dighton, Kansas, the specific data provided does not include comparative averages for the state or county, so no direct comparison to regional pricing standards can be made at this time. Patients should note that paying cash upfront may offer a financial advantage if their insurance plan's negotiated rate exceeds the cash price, though in this specific case, the rates are identical.
To ensure you receive the best possible price, it is important to verify your specific insurance plan's allowed amount before scheduling, as in-network rates can vary significantly between payers. Although the data shows a range of $104 to $126 for various payers, the facility's standard negotiated rate is fixed at $115.00. If you are self-pay or have a high-deductible plan, you should explicitly ask the billing department about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% when paid in full before services are rendered. Additionally, if you receive an itemized bill later, request a full line-by-line audit to confirm that all charges align with the agreed-upon rate and that no unbundled codes or services not rendered have been included.