Speech therapy (language evaluation)
Facility: Nemaha Valley Community Hospital
Billing Code: 92507 (CPT)
- CPT Billing Code: 92507
- Insurance Median: $77
- Cash Discount Price: $133
- vs. Medicare Baseline: 1.01x 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 |
|---|---|---|
| Humana | $65 | 85% |
| Va Ccn - All Plans | $65 | 85% |
| Aetna | $66 - $126 | 87% |
| Celtic Comm Exch - All Plans | $72 | 95% |
| Partners Direct Health - All Plans | $77 | 101% |
| Blue Cross Blue Shield | $78 | 102% |
| Multiplan - All Plans | $133 | 175% |
| Midlands Choice - All Plans | $141 | 185% |
| Health Partners - All Plans | $141 | 185% |
Consumer Guidance & Cost Commentary
For the speech therapy language evaluation service (CPT 92507) at Nemaha Valley Community Hospital in Seneca, Kansas, the facility's cash price of $133.00 is notably higher than the median negotiated rate of $77.00 paid by insurance carriers. While the facility is a Critical Access Hospital with a voluntary non-profit ownership, patients should be aware that commercial insurance rates often include administrative overhead and contractual ceilings that can exceed the direct cash price. In this specific case, the cash rate is $56.00 more than the median negotiated amount, suggesting that for patients with high-deductible plans or those seeking to minimize out-of-pocket costs, paying the cash price directly could result in a lower total expense compared to the standard insurance allowed amount.
To ensure you are receiving the most favorable rate, it is crucial to verify your specific plan's negotiated rate before scheduling, as commercial payers like Aetna and Multiplan may have different contract terms than the state average. Additionally, since the facility offers prompt-pay discounts for upfront payments, you should explicitly request a self-pay classification and ask about potential fee reductions before check-in to avoid automatic claims submission that might void cash savings. Given that the Medicare benchmark for this service is $76.15, the facility's cash price represents a markup above the federal baseline, but the negotiated rates of $77.00 to $141.00 across various payers demonstrate significant variation in how different insurers price this procedure within the county.