Speech therapy (language evaluation)
Facility: St Luke Hospital & Living Center
Billing Code: 92507 (CPT)
- CPT Billing Code: 92507
- Insurance Median: $51
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.67x 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 |
|---|---|---|
| Ambetter / Centene | $33 - $69 | 43% |
| Kansas Department Of Health And Environment | $33 - $68 | 43% |
| Va Ccn | $33 - $68 | 43% |
| Blue Cross Blue Shield | $33 - $68 | 43% |
| Humana | $33 - $68 | 43% |
| Bluestem Pace | $33 - $68 | 43% |
| UnitedHealthcare | $33 - $68 | 43% |
Consumer Guidance & Cost Commentary
For the speech therapy evaluation service (CPT 92507) at St Luke Hospital & Living Center in Marion, KS, the facility's negotiated rates range from $33 to $69, with a median negotiated amount of $51.00. This commercial rate is significantly higher than the Medicare benchmark of $76.15, which serves as the federally established baseline for the true cost of care. While the facility is a Critical Access Hospital owned by a Government Hospital District, patients should note that cash-pay options are not listed in this report. However, for individuals with high-deductible plans where insurance coverage might exceed the cash price, paying out-of-pocket could potentially result in lower out-of-pocket costs. It is always advisable to contact the hospital directly to inquire about "self-pay" or "prompt-pay" discounts, which can reduce bills by 20% to 50% if paid in full upfront.
The data provided does not include specific cash or median paid amounts for this service, so a direct comparison to state or county averages for these specific rates cannot be calculated from the available information. Nevertheless, the facility's gross charge of $99.00 represents the maximum list price before any discounts or insurance negotiations are applied. Under the No Surprises Act, patients are protected from balance billing for out-of-network services at in-network facilities, though unexpected charges may still arise from ancillary services like emergency physicians or labs. To ensure accuracy, patients should request a detailed, itemized bill that lists every specific CPT code and unit cost, as summary bills often obscure errors or unbundled charges. Disputing any discrepancies should be done in writing to the billing supervisor to formally