Speech therapy (language evaluation)
Facility: Memorial Hospital
Billing Code: 92507 (CPT)
- CPT Billing Code: 92507
- Insurance Median: $237
- Cash Discount Price: $430
- vs. Medicare Baseline: 3.11x 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 311% of the Medicare baseline (a markup of 211%). 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 | $82 | 108% |
| Humana | $215 | 282% |
| Tricare | $215 | 282% |
| Medicare (plans) | $217 | 285% |
| Ambetter / Centene | $236 | 310% |
| Coventry - All Other Plans | $387 | 508% |
| Health Partners Of Kansas - All Plans | $408 | 536% |
| Preferred Healthcare-All Plans | $408 | 536% |
| Wppa/Providers Care-All Plans | $602 | 791% |
Consumer Guidance & Cost Commentary
For the speech therapy language evaluation (CPT 92507) at Memorial Hospital in Abilene, KS, the cash price is $430.00, which matches the facility's median negotiated rate of $237.00. This cash price is significantly higher than the Medicare benchmark of $76.15, reflecting a markup typical of commercial billing structures. While the facility is a Critical Access Hospital owned by a Government Hospital District, patients should note that commercial insurance negotiated rates for this service range from $82 for Blue Cross Blue Shield up to $602 for Wppa/Providers Care. Because the cash price ($430.00) is lower than the highest negotiated rates in this dataset, paying out-of-pocket may result in a lower total cost for patients with high-deductible plans who have not yet met their insurance thresholds.
To minimize costs, patients should proactively request "self-pay" or "prompt-pay" discounts before scheduling their visit, as these upfront payment incentives can bypass administrative fees and reduce the final bill. It is also important to verify your specific plan's allowed amount, as in-network rates vary widely among the nine payers listed, with some plans paying significantly less than the facility's cash price. Finally, if you receive a bill that includes charges beyond the negotiated or cash rate, you should request a full itemized audit to identify any errors, unbundled codes, or services not rendered, as over 80% of hospital bills contain discrepancies that can be resolved through formal dispute processes.