Speech therapy (language evaluation)
Facility: Medicine Lodge Memorial Hospital
Billing Code: 92507 (CPT)
- CPT Billing Code: 92507
- Insurance Median: $95
- Cash Discount Price: $100
- vs. Medicare Baseline: 1.25x 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 |
|---|---|---|
| Tricare | $80 | 105% |
| Humana | $91 | 120% |
| Aetna | $93 - $100 | 122% |
| UnitedHealthcare | $95 | 125% |
| Hpk-All Plans | $95 | 125% |
| Medicaid / KanCare | $100 | 131% |
Consumer Guidance & Cost Commentary
For the speech therapy language evaluation service (CPT 92507) at Medicine Lodge Memorial Hospital in Medicine Lodge, Kansas, the cash price is $100.00, which matches the facility's gross chargemaster. This cash rate is notably higher than the state average of $95.00, meaning patients paying out-of-pocket are paying a premium compared to the typical negotiated rate in Kansas. While commercial insurance plans like Aetna and UnitedHealthcare negotiate rates ranging from $91 to $100, these amounts often exceed the cash price, suggesting that for patients with high-deductible plans, paying the full cash price of $100.00 upfront could result in lower out-of-pocket costs than relying on insurance reimbursement.
The facility's negotiated rates average $95.00, which aligns with the state median but remains significantly above the Medicare benchmark of $76.15. This indicates a markup of 120% relative to the federal government's cost-based reimbursement, a figure that falls within the range of fair pricing but highlights the substantial difference between commercial contracts and federal standards. To maximize savings, patients should verify their specific plan's allowed amount before scheduling, as some in-network contracts may offer higher reimbursement than the cash price. Additionally, since the facility is a Critical Access Hospital owned by a government authority, patients should proactively ask about self-pay or prompt-pay discounts before check-in, as paying the bill in full within a short window can often bypass administrative fees and reduce the final amount owed.