Speech therapy (language evaluation)
Facility: Wilson Medical Center
Billing Code: 92507 (CPT)
- CPT Billing Code: 92507
- Insurance Median: $122
- Cash Discount Price: $115
- vs. Medicare Baseline: 1.60x 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 | $77 - $153 | 101% |
| Ambetter / Centene | $81 - $153 | 106% |
| UnitedHealthcare | $81 - $142 | 106% |
| Tricare | $81 | 106% |
| Aetna | $81 - $153 | 106% |
| Humana | $81 | 106% |
| Cigna | $122 | 160% |
| Mulitplan-All Plans | $141 | 185% |
| Health Partners-All Plans | $141 | 185% |
Consumer Guidance & Cost Commentary
For this speech therapy evaluation at Wilson Medical Center in Neodesha, KS, the facility's cash price of $115.00 is lower than the average negotiated rates paid by major insurers, which range from $81 to $153 depending on the plan. While the facility is a government-owned Critical Access Hospital, patients with high-deductible plans may find paying the cash price directly more cost-effective than relying on insurance, as the negotiated rates often exceed the cash amount. It is important to verify your specific plan's allowed amount before scheduling, as some commercial payers may negotiate higher rates than the cash price, potentially resulting in higher out-of-pocket costs if your deductible has not yet been met.
To ensure you are not overcharged, always request a full itemized bill before paying, as summary invoices can hide unbundled codes or services not rendered. If you receive a balance bill for out-of-network services, you may be entitled to protections under the No Surprises Act, which bans surprise billing for emergency care and non-emergency services at in-network facilities. Additionally, ask the billing department about prompt-pay discounts, which can reduce the total cost by 20% to 50% if you pay in full upfront, bypassing the administrative costs associated with insurance claims processing.