Speech therapy (language evaluation)
Facility: Great Plains Of Sabetha
Billing Code: 92507 (CPT)
- CPT Billing Code: 92507
- Insurance Median: $147
- Cash Discount Price: $155
- vs. Medicare Baseline: 1.93x 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 |
|---|---|---|
| Celtic Mcr Adv | $81 | 106% |
| Aetna | $81 - $157 | 106% |
| Celtic Comm Exchange-All Other Plans | $101 | 133% |
| Great West Healthcare-All Plans | $132 | 173% |
| UnitedHealthcare | $144 - $155 | 189% |
| Century/Wppa/Providers-All Plans | $147 | 193% |
| Multiplan-Phcs-All Plans | $147 | 193% |
| Cigna | $147 | 193% |
| Humana | $147 | 193% |
| Federated Mutual Ins-All Plans | $149 | 196% |
| Blue Cross Blue Shield | $155 | 204% |
| Medicaid / KanCare | $155 | 204% |
Consumer Guidance & Cost Commentary
For the speech therapy evaluation service (CPT 92507) at Great Plains Of Sabetha in Sabetha, Kansas, the facility's cash price of $155.00 is identical to the state average and represents the highest possible charge. While commercial insurers negotiate rates ranging from $81 to $155 depending on the plan, these negotiated amounts often exceed the cash price, meaning patients with high-deductible plans might save money by paying out-of-pocket. It is important to note that the facility's median negotiated rate of $147.00 is still higher than the Medicare benchmark of $76.15, which serves as the objective baseline for fair pricing. Because the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, patients should verify their specific plan's allowed amount before scheduling to ensure they are not paying more than necessary.
To minimize costs, patients should proactively ask the billing department about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% if paid upfront. Since the facility's cash rate matches the gross charge, there is no room for negotiation on the list price, but paying in full before the insurance claim is processed can bypass administrative fees and potential balance billing. Additionally, if you have received a bill, request a full itemized statement to review every CPT code and unit charge, as over 80% of hospital bills contain errors such as unbundled services or charges for items not rendered. Always confirm your deductible status before using insurance, as paying the negotiated rate without meeting your deductible may result in higher out-of-pocket expenses than paying the cash price