Speech therapy (language evaluation)
Facility: William Newton Hospital
Billing Code: 92507 (CPT)
- CPT Billing Code: 92507
- Insurance Median: $115
- Cash Discount Price: $320
- vs. Medicare Baseline: 1.51x 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 | $74 - $115 | 97% |
| Triwest- All Plans | $112 | 147% |
| UnitedHealthcare | $115 - $288 | 151% |
| Ambetter / Centene | $115 - $320 | 151% |
| Providrs Care Nexus | $196 | 257% |
| Providrs Care - All Other Plans | $224 | 294% |
Consumer Guidance & Cost Commentary
For the speech therapy language evaluation service (CPT 92507) at William Newton Hospital in Winfield, Kansas, the cash price is $320.00, which matches the facility's gross charge and the median cash rate for this procedure in the state. While the hospital is a Critical Access Hospital owned by the local government, the negotiated rates paid by commercial insurers range from $74 to $320, with a median negotiated amount of $115.00. This indicates that for patients with high-deductible plans who have not yet met their coverage threshold, paying the full cash price of $320.00 may be more cost-effective than using insurance, as the insurer's allowed amount often exceeds the cash rate. However, patients should verify their specific plan's deductible status and confirm whether the facility offers self-pay or prompt-pay discounts before scheduling to ensure they are not paying the maximum negotiated rate.
The facility's pricing is significantly higher than the Medicare benchmark, with the Medicare amount set at $76.15 and the facility charging 1.5 times that rate. This markup reflects the administrative costs and contract dynamics inherent in commercial billing, where negotiated rates often include layers of claims processing and utilization review that inflate the baseline price. To avoid unexpected costs, patients should request an itemized billing audit to review every line item and ensure no services were double-billed or unbundled, as over 80% of hospital bills contain errors. Furthermore, if a patient receives care from an out-of-network provider at this in-network facility, they may be subject to balance billing, though the No Surprises Act provides protections for emergency and non-emergency services. It