Speech therapy (language evaluation)
Facility: Mitchell County Hospital Health Systems
Billing Code: 92507 (CPT)
- CPT Billing Code: 92507
- Insurance Median: $241
- Cash Discount Price: $229
- vs. Medicare Baseline: 3.16x 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 316% of the Medicare baseline (a markup of 216%). 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 | $73 - $254 | 96% |
| Blue Cross Blue Shield | $78 | 102% |
| Triwest Well Mark All Plans | $216 | 284% |
| First Health-All Plans | $229 | 301% |
| Aetna | $229 | 301% |
| Pref Hlth Care Sytms Comm - All Plans | $229 | 301% |
| Auxiant-All Plans | $241 | 316% |
| Multiplan Ppo - All Plans | $241 | 316% |
| Phc Leased Ntwrk Access - All Plans | $241 | 316% |
| Health Partners Ks-All Plans | $251 | 330% |
| Cigna | $251 | 330% |
Consumer Guidance & Cost Commentary
For the speech therapy language evaluation service (CPT 92507) at Mitchell County Hospital Health Systems in Beloit, KS, the cash price is $229.00, which aligns with the facility's median negotiated rate of $241.00. This cash price is significantly lower than the gross charge of $254.00 and represents a substantial discount compared to the commercial negotiated rates paid by various insurers, which range from $73 to $254. While the facility is a Critical Access Hospital with government local ownership, patients should note that commercial payers like UnitedHealthcare and Blue Cross Blue Shield have negotiated rates as low as $73 and $78 respectively, though these vary by plan. For individuals with high-deductible plans, paying the cash price of $229.00 upfront may be more cost-effective than relying on insurance, as the negotiated rates for some carriers exceed the cash amount, and the facility offers prompt-pay discounts for upfront payment.
To ensure you are receiving the most accurate pricing, it is important to request an itemized billing audit rather than accepting a summary bill, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. When reviewing your statement, verify that charges for specific components like sutures or scalpel blades are not billed separately from the main procedure code, as these should be bundled. Additionally, while the Medicare benchmark for this service is $76.15, commercial rates often average 200% to 300% of this amount due to administrative costs and contract dynamics; however, the facility's cash rate of $229