Speech therapy (language evaluation)
Facility: Phillips County Hospital
Billing Code: 92507 (CPT)
- CPT Billing Code: 92507
- Insurance Median: $97
- Cash Discount Price: $91
- vs. Medicare Baseline: 1.27x 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 | $78 - $87 | 102% |
| UnitedHealthcare | $86 - $107 | 113% |
| Medicaid / KanCare | $107 | 141% |
| Health Partners-All Plans | $107 | 141% |
Consumer Guidance & Cost Commentary
For this speech therapy evaluation at Phillips County Hospital in Phillipsburg, Kansas, the facility's cash price of $91.00 is notably lower than the state average of $107.00, offering a potential savings for patients with high-deductible plans. While the facility's negotiated rates with major payers like Blue Cross Blue Shield and UnitedHealthcare range from $78.00 to $107.00, the cash price remains competitive, especially when compared to the Medicaid and KanCare standard rate of $107.00. Patients should verify their specific plan's deductible status before scheduling, as paying the cash price upfront may result in immediate coverage without waiting for administrative processing delays.
When reviewing your final bill, it is crucial to request an itemized statement rather than accepting a summary invoice, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. If you receive a balance bill for the difference between the provider's chargemaster and your insurance allowed amount, you may be protected under the No Surprises Act, which bans surprise billing for emergency care and non-emergency services at in-network facilities. Additionally, consider asking the hospital about prompt-pay discounts, which can reduce the total cost by 20% to 50% if you settle the bill in full within 30 days, effectively bypassing the administrative overhead associated with insurance claims.