Speech therapy (language evaluation)
Facility: Smith County Memorial Hospital
Billing Code: 92507 (CPT)
- CPT Billing Code: 92507
- Insurance Median: $112
- Cash Discount Price: $119
- vs. Medicare Baseline: 1.47x 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 | $77 | 101% |
| Medicaid / KanCare | $84 - $119 | 110% |
| Multiplan-All Plans | $107 | 141% |
| Wppa-All Plans | $112 | 147% |
| UnitedHealthcare | $113 | 148% |
| Midlands Choice-All Plans | $113 | 148% |
| Health Partners Of Ks Ppo-All Plans | $113 | 148% |
Consumer Guidance & Cost Commentary
For the speech therapy language evaluation (CPT 92507) at Smith County Memorial Hospital in Smith Center, KS, the cash price is $119.00, which matches the facility's gross charge and the median cash rate reported for this procedure. While the hospital is a Critical Access Hospital owned by the local government, the negotiated rates paid by insurance payers range from $77 to $119, with a median negotiated amount of $112.00. This data highlights a common pricing dynamic where cash prices can be equal to or lower than insurance negotiated rates; for patients with high-deductible plans or those without coverage, paying the full cash price of $119.00 may be more cost-effective than relying on insurance, which could result in a higher out-of-pocket cost once deductibles and copays are applied.
To ensure you are not overcharged, it is important to understand that commercial insurance rates often include administrative overhead and do not represent the true cost of care, whereas Medicare rates serve as a more reliable benchmark for fair pricing. In this case, the Medicare amount for this service is $76.15, which is significantly lower than both the cash and negotiated rates. If you receive a bill from an out-of-network provider or encounter unexpected charges, you may be subject to balance billing, where the provider bills you for the difference between their full charge and what your insurance paid. Additionally, hospital bills often come as summary invoices that hide specific line items; requesting a detailed, itemized audit is the most effective way to identify errors, unbundled codes, or services not rendered before finalizing payment.