Speech therapy (language evaluation)
Facility: Graham County Hospital
Billing Code: 92507 (CPT)
- CPT Billing Code: 92507
- Insurance Median: $98
- Cash Discount Price: $110
- vs. Medicare Baseline: 1.29x 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 | $77 | 101% |
| Medicare (plans) | $82 | 108% |
| UnitedHealthcare | $88 - $123 | 116% |
| Celtic Commercial-All Other Plans | $91 | 120% |
| Wppa (Providers Care)-All Plans | $104 | 137% |
| Medicaid / KanCare | $123 | 162% |
Consumer Guidance & Cost Commentary
This report details the pricing for CPT code 92507, Speech therapy (language evaluation), at Graham County Hospital in Hill City, Kansas. The facility's cash median rate is $110.00, which matches the gross chargemaster price. While the facility is a Critical Access Hospital owned by the local government, the negotiated rates paid by insurance payers vary significantly, ranging from $77 for Blue Cross Blue Shield to $123 for Medicaid/KanCare. It is important to note that for patients with high-deductible plans, paying the cash price of $110.00 upfront may be more cost-effective than relying on insurance, as the negotiated rates paid by insurers often exceed the cash price due to administrative overhead and contract dynamics. Patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront fee reductions can lower the final cost.
When evaluating the value of this service, it is crucial to compare rates against the Medicare benchmark rather than the inflated hospital list price. The Medicare amount for this procedure is $76.15, and the facility's negotiated average of $98.00 represents a markup relative to this federal baseline. Although the data provided does not include specific state or county average figures for comparison, the Medicare rate serves as the scientifically validated cost baseline for healthcare delivery in this region. Consumers should be aware that balance billing is generally prohibited for out-of-network services at in-network facilities under the No Surprises Act, but they must still review itemized bills carefully to ensure no unbundled codes or services not rendered are included. Disputing any errors in writing with the billing supervisor is the most