Speech therapy (language evaluation)
Facility: Community Memorial Healthcare, Inc.
Billing Code: 92507 (CPT)
- CPT Billing Code: 92507
- Insurance Median: $75
- Cash Discount Price: $127
- vs. Medicare Baseline: 0.98x 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 |
|---|---|---|
| Aetna | $58 - $102 | 76% |
| UnitedHealthcare | $73 | 96% |
| Blue Cross Blue Shield | $78 | 102% |
Consumer Guidance & Cost Commentary
For the speech therapy language evaluation service (CPT 92507) at Community Memorial Healthcare, Inc. in Marysville, KS, the cash price is $127.00, which matches the facility's median negotiated rate of $127.00. While the facility's cash price is significantly higher than the state average of $76.15 (Medicare amount), it is important to note that commercial insurance negotiated rates often exceed cash prices due to administrative overhead and contract structures. In this specific case, the median allowed amount for in-network payers is $102.00, which is lower than the cash price, meaning patients with high-deductible plans or those paying out-of-pocket might save money by paying the cash rate directly rather than relying on insurance reimbursement.
Patients should be aware that while the No Surprises Act protects against balance billing for out-of-network providers at in-network facilities, unexpected charges can still occur if ancillary services are not covered under the same contract. To avoid potential errors or double-billing, consumers should request a detailed, itemized bill before paying, as summary bills often obscure individual code costs. Additionally, since the facility offers a prompt-pay discount for upfront payment, patients should explicitly ask the billing department about self-pay or prompt-pay rates prior to scheduling to ensure they are not inadvertently submitting a claim that voids these discounts.