Speech therapy (language evaluation)
Facility: Kiowa District Hospital
Billing Code: 92507 (CPT)
- CPT Billing Code: 92507
- Insurance Median: $175
- Cash Discount Price: $148
- vs. Medicare Baseline: 2.30x 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 230% of the Medicare baseline (a markup of 130%). 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 |
|---|---|---|
| Tricare | $72 | 95% |
| Blue Cross Blue Shield | $77 | 101% |
| Healthchoice-All Plans | $120 | 158% |
| UnitedHealthcare | $148 - $185 | 194% |
| Health Partners Of Ks-All Plans | $163 | 214% |
| Humana | $167 | 219% |
| Multiplan-All Plans | $174 | 228% |
| Gbs Insurance - All Plans | $174 | 228% |
| Triwest-All Plans | $176 | 231% |
| Aetna | $176 | 231% |
| Medicare (plans) | $176 | 231% |
| Medicaid / KanCare | $185 | 243% |
| Providers Care (Wppa)-All Plans | $278 | 365% |
| Liberty Healthshare-All Plans | $299 | 393% |
Consumer Guidance & Cost Commentary
For the speech therapy language evaluation service (CPT 92507) at Kiowa District Hospital in Kiowa, Kansas, the cash median price is $148.00, which is lower than the facility's negotiated rates of $174.00 to $175.00. While commercial payers like UnitedHealthcare and Humana have negotiated rates ranging from $148 to $185, patients with high-deductible plans may find the cash price more advantageous if their insurance allowed amount exceeds the cash rate. It is important to note that this facility is a Critical Access Hospital owned by a Government Hospital District, and patients should explicitly ask for "self-pay" or "prompt-pay" discounts before scheduling to potentially lower the final cost.
The facility's pricing structure reflects standard billing dynamics where commercial negotiated rates often exceed cash prices due to administrative overhead and contract structures. Although the data does not provide specific state or county average comparisons for this service, the Medicare benchmark of $76.15 serves as a baseline, with commercial rates generally falling between 120% and 300% of this amount depending on the payer. Patients should be aware of balance billing protections under the No Surprises Act, which prevent out-of-network balance billing for emergency care and non-emergency services at in-network facilities, and should always request an itemized bill to verify that all charges are accurate and that no unbundled codes or services not rendered have been included.