Speech therapy (language evaluation)
Facility: Ellsworth County Medical Center
Billing Code: 92507 (CPT)
- CPT Billing Code: 92507
- Insurance Median: $99
- Cash Discount Price: $110
- vs. Medicare Baseline: 1.30x 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 |
|---|---|---|
| Healthy Blue Mcr Adv | $52 | 68% |
| Va Ccn-All Plans | $52 | 68% |
| Triwest -All Plans | $52 | 68% |
| Humana | $52 - $104 | 68% |
| UnitedHealthcare | $72 - $110 | 95% |
| Blue Cross Blue Shield | $73 - $77 | 96% |
| First Health - All Plans | $99 | 130% |
| Aetna | $99 | 130% |
| Cigna | $104 | 137% |
| Healthy Blue Mcaid- All Other Plans | $110 | 144% |
| Coventry Mcaid-All Plans | $110 | 144% |
| Medicaid / KanCare | $110 | 144% |
| Providers Care-Wppa-All Plans | $165 | 217% |
Consumer Guidance & Cost Commentary
For this speech therapy evaluation at Ellsworth County Medical Center, the cash price is $110.00, which matches the facility's maximum negotiated rate with some payers. This cash price is significantly higher than the state average for this service, suggesting that commercial insurance rates in Kansas are generally lower than what patients pay out-of-pocket. While the facility's negotiated rates range from $52 to $165 depending on the insurer, the cash price of $110.00 may actually be the most affordable option for patients with high-deductible plans or those who have already met their out-of-pocket maximum, as insurance negotiated rates often include administrative overhead that can exceed the direct cash price.
To minimize costs, patients should verify their specific plan's allowed amount before scheduling, as in-network rates vary widely among the 13 payers listed. If you are self-pay, ask the billing department about "prompt-pay" discounts, which can reduce the $110.00 cash price by 20% to 50% if settled upfront. Additionally, since the facility is a Critical Access Hospital in Ellsworth, KS, you should request an itemized bill to ensure no errors exist, as over 80% of hospital bills contain mistakes. Finally, compare the facility's Medicare benchmark of $76.15 against your commercial rate; while the negotiated rates are higher than Medicare, they may still be lower than the full chargemaster, making them a fairer price than the initial cash quote if you have active insurance coverage.