Speech therapy (language evaluation)
Facility: Goodland Regional Medical Center
Billing Code: 92507 (CPT)
- CPT Billing Code: 92507
- Insurance Median: $212
- Cash Discount Price: $212
- vs. Medicare Baseline: 2.78x 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 278% of the Medicare baseline (a markup of 178%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $78 | 102% |
| Wppa | $200 - $212 | 263% |
| UnitedHealthcare | $212 | 278% |
Consumer Guidance & Cost Commentary
For the speech therapy language evaluation service (CPT 92507) at Goodland Regional Medical Center in Goodland, Kansas, the cash price is $212.00, which matches the median negotiated rate for in-network payers like Wppa and UnitedHealthcare. This cash price is significantly lower than the facility's gross charge of $235.00 and represents a substantial discount compared to the Medicare benchmark of $76.15. While the facility is a Critical Access Hospital with a government-local ownership structure, patients should be aware that commercial insurance rates often exceed cash prices due to administrative overhead and contract dynamics. In this specific case, paying cash directly may result in a lower out-of-pocket cost than using insurance, provided the patient's deductible has been met and the negotiated rate does not exceed the cash amount.
To avoid unexpected costs, patients should explicitly ask the billing department about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can further reduce the total bill. If a patient receives a bill from an out-of-network provider or encounters unexpected charges, they should request a formal itemized audit to identify errors, unbundled codes, or services not rendered, as over 80% of hospital bills contain inaccuracies. Additionally, under federal protections like the No Surprises Act, patients are generally shielded from balance billing for emergency care and non-emergency services at in-network facilities, though verifying the network status of all ancillary services is crucial. Given that the facility is located in a rural area (ZIP 67735), comparing the $212.00 cash rate to local state averages ensures the patient is receiving