Speech therapy (language evaluation)
Facility: Fredonia Regional Hospital
Billing Code: 92507 (CPT)
- CPT Billing Code: 92507
- Insurance Median: $101
- Cash Discount Price: $112
- vs. Medicare Baseline: 1.33x 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 |
|---|---|---|
| Blue Cross Blue Shield | $56 - $78 | 74% |
| Veterans Programs - All Plans | $57 | 75% |
| Aetna | $57 - $101 | 75% |
| UnitedHealthcare | $57 - $179 | 75% |
| Reserve National-All Plans | $101 | 133% |
| Meritain-All Plans | $101 | 133% |
| Cigna | $101 | 133% |
Consumer Guidance & Cost Commentary
For the speech therapy language evaluation service (CPT 92507) at Fredonia Regional Hospital in Fredonia, Kansas, the cash price is $112.00, which matches the facility's median negotiated rate of $101.00 and the cash median. This service is provided by a Critical Access Hospital with government local ownership. While the facility's cash price is identical to its negotiated rate, patients should be aware that commercial insurance plans often negotiate rates higher than cash prices; for example, UnitedHealthcare's range extends up to $179, and Aetna's range reaches $101. Because insurance billing involves administrative overhead and contractual structures that can inflate costs, paying cash upfront may result in a lower out-of-pocket expense compared to using an insurance plan where the allowed amount exceeds the cash price.
To ensure you receive the most accurate and lowest possible price, it is essential to request a full itemized bill before paying, as summary bills often obscure individual charges and errors. If you receive a balance bill for the difference between the provider's chargemaster rate and your insurance allowed amount, you may be protected by the No Surprises Act, which bans balance billing for out-of-network providers at in-network facilities. Additionally, since the facility offers prompt-pay discounts for upfront payment, you should explicitly ask to be classified as a self-pay patient prior to scheduling to avoid automatic claims submission that could void any cash savings. Always verify your deductible status before using insurance, as paying the full negotiated rate without meeting your deductible can be significantly more expensive than the cash option.