Speech therapy (language evaluation)
Facility: Kiowa County Memorial Hospital
Billing Code: 92507 (CPT)
- CPT Billing Code: 92507
- Insurance Median: $98
- Cash Discount Price: $94
- 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 | $78 - $98 | 102% |
| UnitedHealthcare | $88 - $110 | 116% |
| Health Partners Of Ks-All Plans | $97 | 127% |
| Medica Prime Mcare Cost-All Plans | $98 | 129% |
| Celtic Comml Exchange-All Other Plans | $98 | 129% |
| Aetna | $98 | 129% |
| Humana | $98 | 129% |
| Medicaid / KanCare | $110 | 144% |
| Providrs Care/Wppa-All Plans | $165 | 217% |
Consumer Guidance & Cost Commentary
For this speech therapy evaluation at Kiowa County Memorial Hospital, the negotiated rates across major payers range from $78 to $165, with a median negotiated amount of $98. This figure is notably higher than the facility's cash price of $94, illustrating a common billing dynamic where insurance contracts often exceed self-pay rates due to administrative overhead and claim processing costs. While the facility is a Critical Access Hospital in Greensburg, KS, with government-local ownership, patients should be aware that paying cash upfront can sometimes result in lower out-of-pocket costs if their insurance negotiated rate exceeds the cash price. To maximize savings, it is advisable to explicitly request "self-pay" or "prompt-pay" discounts before scheduling, as these upfront incentives can bypass the standard insurance billing cycle and reduce the final bill.
When reviewing your final statement, be cautious of summary bills that obscure individual charges, as over 80% of hospital bills contain errors such as double-billing or unbundled codes. If you receive a bill, always demand a full itemized CPT-coded statement to identify any services not rendered or charges that should be bundled. Furthermore, your commercial rate should be evaluated against the Medicare benchmark of $76.15 rather than the hospital's gross charge of $110; comparing your allowed amount to this federal baseline reveals the true markup of the facility's pricing. If you encounter unexpected balance billing from out-of-network providers, remember that the No Surprises Act protects you from paying the difference for emergency care and non-emergency services at in-network facilities, and you should dispute any such bills in writing rather than accepting them immediately.