Speech therapy (language evaluation)
Facility: Ashland Health Center
Billing Code: 92507 (CPT)
- CPT Billing Code: 92507
- Insurance Median: $108
- Cash Discount Price: $86
- vs. Medicare Baseline: 1.42x 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 |
|---|---|---|
| Blue Cross Blue Shield | $36 | 47% |
| Compalliance-All Plans | $86 | 113% |
| Health Partners Of Kansas-All Plans | $92 | 121% |
| Multiplan-All Plans | $106 | 139% |
| Health Choice-All Plans | $108 | 142% |
| Medica Mcare - All Plans | $108 | 142% |
| Medicaid / KanCare | $108 | 142% |
| Medicare (plans) | $108 | 142% |
| Healthy Blue Mcr Adv - All Other Plans | $108 | 142% |
| Aetna | $108 | 142% |
| UnitedHealthcare | $108 | 142% |
| Providers Care (Wppa)-All Plans | $162 | 213% |
Consumer Guidance & Cost Commentary
For the speech therapy language evaluation service (CPT 92507) at Ashland Health Center in Ashland, Kansas, the facility's negotiated rates are $108, which matches the median amount paid across all payers. This rate is 40% higher than the Medicare benchmark of $76.15, indicating a markup of 1.4 times the federal standard. While the facility is a voluntary non-profit Critical Access Hospital, the cash price of $86 is lower than the negotiated rate, suggesting that patients with high-deductible plans or those without insurance might save money by paying cash directly. However, because the negotiated rate is identical across most commercial plans, the primary benefit of using insurance here is coverage rather than a lower price point.
Patients should be aware that while the facility offers a cash price of $86, they should explicitly ask about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can further reduce the final cost. It is important to note that the $108 negotiated rate serves as a ceiling for in-network billing, but this does not guarantee the lowest possible price if the patient's specific plan has unique contract terms. Given that the facility is located in Ashland (ZIP 67831), the fixed negotiated rates reflect the local market dynamics for this specific CPT code, and consumers are advised to verify their specific plan's allowed amount to ensure they are not being billed above their deductible threshold.