Speech therapy (language evaluation)
Facility: F W Huston Medical Center
Billing Code: 92507 (CPT)
- CPT Billing Code: 92507
- Insurance Median: $219
- Cash Discount Price: $228
- vs. Medicare Baseline: 2.88x 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 288% of the Medicare baseline (a markup of 188%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $78 | 102% |
| Aetna | $214 | 281% |
| Humana | $225 | 295% |
| Cigna | $242 | 318% |
Consumer Guidance & Cost Commentary
For the speech therapy language evaluation service (CPT 92507) at F W Huston Medical Center in Winchester, KS, the facility's cash median price of $228.00 is lower than the state average, which stands at $285.00. While the facility's negotiated rates with major payers like Blue Cross Blue Shield ($78), Aetna ($214), and Humana ($225) are significantly lower than the gross charge of $285.00, patients with high-deductible plans may find the cash price more advantageous if their insurance negotiated rate exceeds $228.00. It is important to note that the facility's median negotiated rate of $219.00 is slightly below the cash price, suggesting that for some commercial plans, the out-of-pocket cost could be reduced by paying directly or utilizing prompt-pay discounts before scheduling.
The Medicare benchmark for this procedure is $76.15, which serves as the objective baseline for evaluating the facility's pricing markup. The facility's cash rate of $228.00 represents a 2.9x markup relative to the Medicare amount, while the median negotiated rate of $219.00 remains well below the gross charge, indicating a transparent discount structure. Since this facility is a Critical Access Hospital with voluntary non-profit ownership, patients should verify their specific plan details and ask directly about self-pay or prompt-pay discounts prior to receiving care. To ensure you are not overcharged, always request an itemized bill that breaks down the exact CPT codes and unit costs, avoiding summary bills that may obscure individual charges, and confirm that any