Speech therapy (language evaluation)
Facility: Cloud County Health Center
Billing Code: 92507 (CPT)
- CPT Billing Code: 92507
- Insurance Median: $409
- Cash Discount Price: $301
- vs. Medicare Baseline: 5.37x 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 537% of the Medicare baseline (a markup of 437%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
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 |
|---|---|---|
| Aetna | $387 - $400 | 508% |
| Mpi-All Plans | $408 | 536% |
| Health Partners - All Plans | $408 | 536% |
| Pponext-All Plans | $408 | 536% |
Consumer Guidance & Cost Commentary
For this speech therapy evaluation at Cloud County Health Center in Concordia, KS, the facility's cash price of $301.00 is notably lower than the state average of $409.00, offering a potential savings of $108.00 for self-pay patients. While the facility's negotiated rates with major payers like Aetna, Mpi-All Plans, and Health Partners average $408.00 to $409.00, these amounts are higher than the cash price. If you have a high-deductible plan, paying the cash rate of $301.00 upfront may be more cost-effective than relying on insurance, which could result in a higher allowed amount after deductibles are met. It is important to verify your specific plan's deductible status before scheduling, as paying the full negotiated rate without meeting your deductible can lead to unexpected out-of-pocket costs.
To ensure you are not overcharged, we recommend requesting an itemized bill that lists every specific CPT code and service rendered, as summary bills often hide errors or unbundled charges. Additionally, ask the billing department about "prompt-pay" discounts, which can reduce the final balance by 20% to 50% if you settle the account in full within 30 days. Since the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, they may offer additional self-pay incentives not reflected in the standard negotiated rates. Always dispute any balance billed charges with your insurer if you believe they exceed the No Surprises Act protections, and never sign away your rights to dispute out-of-network costs without fully understanding the waiver terms.