Speech therapy (language evaluation)
Facility: Hamilton County Hospital
Billing Code: 92507 (CPT)
- CPT Billing Code: 92507
- Insurance Median: $208
- Cash Discount Price: $231
- vs. Medicare Baseline: 2.73x 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 273% of the Medicare baseline (a markup of 173%). 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 | $37 - $78 | 49% |
| First Health Coventry - All Plans | $196 | 257% |
| Cigna | $219 | 288% |
| UnitedHealthcare | $219 | 288% |
| Va Ccn - All Plans | $231 | 303% |
| Aetna | $392 | 515% |
Consumer Guidance & Cost Commentary
For the speech therapy language evaluation service (CPT 92507) at Hamilton County Hospital in Syracuse, KS, the cash price is $231.00, which matches the facility's negotiated rate with several payers including Cigna, UnitedHealthcare, and Va Ccn. This cash price is significantly higher than the state average for this procedure, as indicated by a 2.7x multiplier relative to the Medicare benchmark of $76.15. While commercial insurance plans like Blue Cross Blue Shield and First Health Coventry have negotiated rates ranging from $37 to $196, these figures represent the maximum allowed amounts rather than actual patient out-of-pocket costs, which depend heavily on individual deductibles and copays. Patients with high-deductible plans may find that paying the cash price directly is more economical than using insurance, especially if their plan's negotiated rate exceeds the cash amount or if they have not yet met their deductible threshold.
To ensure you are receiving the most accurate pricing, it is essential to request an itemized bill before finalizing payment, as summary invoices often obscure individual charges and may include unbundled codes or services not rendered. If you choose to pay out-of-pocket, ask the billing department specifically about "self-pay" or "prompt-pay" discounts, which can reduce the total cost by 20% to 50% when paid upfront. Additionally, be aware that while the No Surprises Act protects you from balance billing for emergency care and non-emergency services at in-network facilities, unexpected charges can still occur if ancillary services like laboratory tests are provided by out-of-network providers. Always verify your specific plan's allowed amount and deductible status before scheduling