Speech therapy (language evaluation)
Facility: Osborne County Memorial Hospital
Billing Code: 92507 (CPT)
- CPT Billing Code: 92507
- Insurance Median: $213
- Cash Discount Price: $200
- vs. Medicare Baseline: 2.80x 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 280% of the Medicare baseline (a markup of 180%). 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 |
|---|---|---|
| UnitedHealthcare | $179 | 235% |
| Health Partners Of Kansas | $202 | 265% |
| Wppa | $223 | 293% |
| Blue Cross Blue Shield | $230 | 302% |
Consumer Guidance & Cost Commentary
For the speech therapy language evaluation (CPT 92507) at Osborne County Memorial Hospital in Osborne, KS, the facility's cash price of $200.00 is notably lower than the negotiated rates charged by commercial payers, which range from $179 to $230 depending on the specific insurance plan. This service is provided by a Critical Access Hospital with government-local ownership, and while the facility's cash rate is competitive, it is important to note that commercial insurance contracts often result in higher out-of-pocket costs for patients who have not yet met their deductibles. The negotiated rates for this procedure reflect the administrative costs and contract structures of major insurers like UnitedHealthcare, Health Partners Of Kansas, Wppa, and Blue Cross Blue Shield, which typically exceed the direct cash price due to multi-layered billing processes.
When evaluating the cost of this service, it is essential to compare the facility's pricing against the Medicare benchmark, which stands at $76.15 for this code. The facility's cash rate of $200.00 represents a significant markup over the federal baseline, illustrating how commercial pricing can differ substantially from government-set rates. 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 properly coordinated. To minimize costs, patients are encouraged to verify their deductible status before scheduling and to inquire directly with the hospital about potential "self-pay" or "prompt-pay" discounts, which can offer immediate fee reductions for upfront payment.