Speech therapy (language evaluation)
Facility: Wichita County Health Center
Billing Code: 92507 (CPT)
- CPT Billing Code: 92507
- Insurance Median: $91
- Cash Discount Price: $80
- vs. Medicare Baseline: 1.20x 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 |
|---|---|---|
| Medicaid / KanCare | $82 | 108% |
| UnitedHealthcare | $100 | 131% |
Consumer Guidance & Cost Commentary
For the speech therapy language evaluation service (CPT 92507) at Wichita County Health Center in Leoti, Kansas, the facility's cash price of $80.00 is lower than the state average, which is reflected in the cash median of $80.00. While the facility's negotiated rate with UnitedHealthcare is $100.00, patients with high-deductible plans might find the cash price more advantageous if their insurance allowed amount exceeds $80.00. It is important to note that the facility's negotiated rate of $91.00 is higher than the cash price, illustrating that commercial insurance contracts often include administrative overhead that increases the final cost for insured members compared to self-pay options.
The Medicare benchmark for this service is $76.15, which serves as a baseline for evaluating the facility's pricing structure. The facility's cash rate of $80.00 is slightly above the Medicare amount, while the negotiated rate of $100.00 represents a significant markup relative to the federal standard. Patients should be aware that balance billing is generally prohibited for in-network services under the No Surprises Act, meaning they should not expect to be billed for the difference between the chargemaster and the insurance allowed amount. To minimize costs, consumers are encouraged to request a prompt-pay discount or self-pay rate directly from the billing department before scheduling, as these upfront payments can bypass the higher administrative fees associated with insurance claims processing.