Speech therapy (language evaluation)
Facility: Sheridan County Hospital
Billing Code: 92507 (CPT)
- CPT Billing Code: 92507
- Insurance Median: $107
- Cash Discount Price: $157
- vs. Medicare Baseline: 1.41x 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 Insurance | $95 | 125% |
| Blue Cross Blue Shield | $107 | 141% |
| UnitedHealthcare | $149 | 196% |
Consumer Guidance & Cost Commentary
For the speech therapy language evaluation code 92507 at Sheridan County Hospital in Hoxie, Kansas, the cash price is $157.00, which matches the facility's median cash rate. This cash price is significantly higher than the state average of $76.15, representing a 1.4x markup compared to Medicare rates. While commercial insurance plans like Celtic Insurance, Blue Cross Blue Shield, and UnitedHealthcare have negotiated rates of $95, $107, and $149 respectively, these amounts often exceed the cash price for patients with high-deductible plans. In such cases, paying cash directly can sometimes result in lower out-of-pocket costs than relying on insurance reimbursement, provided the patient qualifies for the cash rate.
Patients should proactively contact the hospital to confirm if "self-pay" or "prompt-pay" discounts are available, as these upfront payment incentives can further reduce the final bill. It is important to understand that commercial negotiated rates often include administrative overhead and do not necessarily reflect the lowest possible price. To ensure accuracy, consumers should request an itemized billing audit before paying, as summary bills may hide unbundled charges or services not rendered. Additionally, if a patient receives a balance bill from an out-of-network provider, they may be entitled to protections under the No Surprises Act, which bans balance billing for emergency and non-emergency services at in-network facilities.