Speech therapy (language evaluation)
Facility: Clay County Medical Center
Billing Code: 92507 (CPT)
- CPT Billing Code: 92507
- Insurance Median: $81
- Cash Discount Price: $87
- vs. Medicare Baseline: 1.06x 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 |
|---|---|---|
| Wppa/Providrs Care- All Plans | $15 - $146 | 20% |
| Aetna | $15 - $146 | 20% |
| UnitedHealthcare | $16 - $150 | 21% |
| Multiplan- All Plans | $16 - $150 | 21% |
| Health Partners - All Plans | $16 - $150 | 21% |
Consumer Guidance & Cost Commentary
For this speech therapy evaluation at Clay County Medical Center in Clay Center, KS, the cash price is $87.00, which matches the facility's cash median. This rate is significantly lower than the state average for this procedure, where commercial payers typically negotiate rates between $15.00 and $150.00 depending on the plan. While the facility is a Critical Access Hospital owned by the local government, patients should be aware that commercial insurance negotiated rates often exceed cash prices due to administrative overhead and contract structures. If you have a high-deductible plan, paying the cash price of $87.00 upfront might be more cost-effective than your insurance paying a negotiated rate that could reach $146.00, especially if your deductible has not yet been met.
To ensure you are not overcharged, it is important to request a full itemized bill before paying, as summary invoices can hide unbundled codes or services not rendered. Although the No Surprises Act protects patients from balance billing for out-of-network providers at in-network facilities, you should still verify that all ancillary services were billed correctly. Additionally, ask the billing department about prompt-pay discounts, which can reduce the final amount by 20% to 50% if you settle the account in full within 30 days. Since the facility's cash rate is already competitive compared to the regional average, securing a prompt-pay discount could further lower your out-of-pocket costs without compromising care.