Speech therapy (language evaluation)
Facility: Jewell County Hospital
Billing Code: 92507 (CPT)
- CPT Billing Code: 92507
- Insurance Median: $173
- Cash Discount Price: $137
- vs. Medicare Baseline: 2.27x 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 227% of the Medicare baseline (a markup of 127%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
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 |
|---|---|---|
| Rural Carriers - All Plans | $155 | 204% |
| Meritain - All Plans | $164 | 215% |
| Aetna | $164 | 215% |
| Midlands Choice - All Plans | $173 | 227% |
| Cigna | $173 | 227% |
| UnitedHealthcare | $173 | 227% |
| First Health - All Plans | $173 | 227% |
Consumer Guidance & Cost Commentary
For this speech therapy evaluation at Jewell County Hospital in Mankato, KS, the negotiated rates paid by major insurers like Aetna, Cigna, and UnitedHealthcare are $173, which matches the median negotiated amount for the region. While these in-network rates provide financial protection against surprise billing, they are notably higher than the facility's cash price of $137. Patients with high-deductible plans or those without insurance may find it beneficial to pay the cash price directly, as it avoids the administrative markup and claims processing fees inherent in the insurance billing cycle. It is important to verify with the hospital whether a "self-pay" or "prompt-pay" discount is available before scheduling, as paying upfront can sometimes result in a fee reduction that further lowers the total cost.
The facility's cash rate of $137 is also lower than the Medicare benchmark of $76.15 when adjusted for the specific service context, though the primary comparison here is between the commercial negotiated rate and the cash option. Since the hospital is a Critical Access Hospital with government local ownership, the pricing structure reflects regional cost data rather than commercial profit margins. Consumers should be aware that while the No Surprises Act protects against balance billing for out-of-network services at in-network facilities, it does not automatically apply to cash-pay scenarios. To ensure you are receiving the most accurate pricing, always request an itemized bill before finalizing payment to confirm that no unbundled codes or services not rendered have been included in the total charge.