Speech therapy (language evaluation)
Facility: Rooks County Health Center
Billing Code: 92507 (CPT)
- CPT Billing Code: 92507
- Insurance Median: $152
- Cash Discount Price: $128
- vs. Medicare Baseline: 2.00x 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 | $78 | 102% |
| Tricare | $80 - $81 | 105% |
| Veterans Admin - All Plans | $80 - $81 | 105% |
| Celtic Mcr Adv | $80 - $81 | 105% |
| Celtic Comm - All Other Plans | $88 - $89 | 116% |
| Aetna | $152 - $155 | 200% |
| Preferred Benefits Admin | $152 - $155 | 200% |
| UnitedHealthcare | $152 - $155 | 200% |
| Health Partners - All Plans | $161 - $164 | 211% |
| Preferred Hlthcare - All Other Plans | $161 - $164 | 211% |
| Healthy Blue Mcaid - All Plans | $169 - $173 | 222% |
Consumer Guidance & Cost Commentary
For the speech therapy language evaluation (CPT 92507) at Rooks County Health Center in Plainville, KS, the facility's cash median rate of $128.00 is notably lower than the negotiated rates paid by most insurance payers, which range from $78 to $173. While the facility's cash price is competitive, patients with high-deductible plans may find that paying the cash rate upfront is more cost-effective than relying on insurance, as the negotiated amounts often exceed the cash price. It is important to note that while the facility is a Critical Access Hospital owned by a Government Hospital District, the specific negotiated rates vary significantly by payer, with some plans like Blue Cross Blue Shield paying $78 and others like Healthy Blue Mcaid paying up to $173.
To ensure you are not overcharged, we recommend requesting an itemized billing audit before finalizing payment, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. Additionally, since the facility offers a cash median rate of $128.00, you should ask about "prompt-pay" discounts or self-pay rates before scheduling, as these can further reduce costs compared to the standard negotiated amounts. If you receive a bill that exceeds these rates, you may be subject to balance billing if you are out-of-network, though the No Surprises Act protects you from such surprise charges for emergency care and non-emergency services at in-network facilities. Always verify your specific plan's allowed amount and deductible status before receiving care to avoid unexpected financial burdens.