Speech therapy (language evaluation)
Facility: Trego County Lemke Memorial Hospital
Billing Code: 92507 (CPT)
- CPT Billing Code: 92507
- Insurance Median: $131
- Cash Discount Price: $163
- vs. Medicare Baseline: 1.72x 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 |
|---|---|---|
| Humana | $94 | 123% |
| Tricare | $102 | 134% |
| Blue Cross Blue Shield | $106 | 139% |
| Medicaid / KanCare | $119 - $192 | 156% |
| UnitedHealthcare | $119 - $192 | 156% |
| Aetna | $119 - $173 | 156% |
| Va Ccn - All Plans | $119 | 156% |
| Ambetter / Centene | $131 | 172% |
| Health Partners - All Plans | $182 | 239% |
| Healthy Blue Mcaid - All Plans | $192 | 252% |
Consumer Guidance & Cost Commentary
For the speech therapy language evaluation (CPT 92507) at Trego County Lemke Memorial Hospital in Wakeeney, KS, the facility's cash price of $163.00 is notably higher than the state average of $119.00, though it aligns with the highest negotiated rates found among commercial payers. While the facility is a Critical Access Hospital with government local ownership, patients should be aware that commercial insurance contracts often result in higher out-of-pocket costs than direct cash payment due to administrative overhead and contract dynamics. For individuals with high-deductible plans, paying the cash price of $163.00 upfront may be more cost-effective than relying on insurance, which could lead to a negotiated rate exceeding the cash amount or require the patient to meet a deductible before coverage applies.
To minimize costs, patients should proactively ask the hospital about "self-pay" or "prompt-pay" discounts, which can reduce the bill by 20% to 50% when paid in full before or shortly after the service. It is also important to request a detailed, itemized bill rather than a summary invoice, as over 80% of hospital bills contain errors such as unbundled codes or charges for services not rendered. Finally, while the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, patients should verify their specific plan details and deductible status before scheduling to ensure they are not facing unexpected costs.