Speech therapy (language evaluation)
Facility: Stanton County Hospital
Billing Code: 92507 (CPT)
- CPT Billing Code: 92507
- Insurance Median: $80
- Cash Discount Price: $114
- vs. Medicare Baseline: 1.05x 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 | $74 - $140 | 97% |
| Healthy Blue Mcr Adv - All Other Plans | $79 - $144 | 104% |
| Healthy Blue Mcaid | $81 - $147 | 106% |
Consumer Guidance & Cost Commentary
For the speech therapy language evaluation service (CPT 92507) at Stanton County Hospital in Johnson, KS, the cash price is $114.00, which matches the facility's cash median. This rate is significantly lower than the negotiated amounts paid by major payers in the area, such as Blue Cross Blue Shield, which averages $107.00 across four plans, and Healthy Blue plans, which range from $79.00 to $147.00. While commercial insurance contracts often cap charges to protect members, these negotiated rates can sometimes exceed the cash price, making out-of-pocket payment a potentially more affordable option for patients with high-deductible plans. Because the facility is a Critical Access Hospital owned by the local government, patients should explicitly ask about "self-pay" or "prompt-pay" discounts before scheduling to ensure they are not billed the full negotiated rate by their insurer.
The Medicare benchmark for this service is $76.15, which serves as a baseline for evaluating the facility's pricing structure. The facility's cash rate of $114.00 represents a markup of approximately 49% over the Medicare amount, aligning with the typical range of fair pricing (120% to 150% of Medicare) rather than the often inflated chargemaster lists. If a patient receives care from an out-of-network provider at this facility, they could face balance billing for the difference between the provider's full charge and the insurance allowed amount, though the No Surprises Act protects against such surprise bills for emergency and non-emergency services at in-network facilities. To avoid unexpected costs, patients should request an itemized bill