Speech therapy (language evaluation)
Facility: Bob Wilson Memorial Hospital
Billing Code: 92507 (CPT)
- CPT Billing Code: 92507
- Insurance Median: $166
- Cash Discount Price: $81
- vs. Medicare Baseline: 2.18x 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 218% of the Medicare baseline (a markup of 118%). 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 | $65 - $169 | 85% |
| Medicare (plans) | $65 | 85% |
| Aetna | $65 - $162 | 85% |
| Kansas Health | $65 | 85% |
| Humana | $65 | 85% |
| Centura Employee Plan | $72 | 95% |
| Blue Cross Blue Shield | $104 | 137% |
| Multiplan | $183 - $189 | 240% |
| Health Partners Of Kansas | $191 | 251% |
| Wppa | $193 | 253% |
Consumer Guidance & Cost Commentary
For the speech therapy language evaluation service (CPT 92507) at Bob Wilson Memorial Hospital in Ulysses, KS, the cash price is $81.00, which is significantly lower than the facility's negotiated rates with major payers like UnitedHealthcare ($65–$169) and Aetna ($65–$162). While the hospital is a Critical Access Hospital owned by a voluntary non-profit church, patients should note that cash payments can sometimes be more cost-effective than using insurance, particularly if your plan has a high deductible or if the negotiated rate exceeds the cash price. The facility offers a self-pay option, and you are encouraged to contact them directly to confirm if "prompt-pay" discounts are available for upfront settlement, which can further reduce the final amount owed.
This service is benchmarked against Medicare, which sets a fixed reimbursement rate of $76.15 for this procedure. The hospital's cash rate of $81.00 is slightly higher than the Medicare amount, but notably lower than the median negotiated rate of $166.00 reported for this code in the region. When reviewing your bill, ensure you receive an itemized statement rather than a summary invoice, as over 80% of hospital bills contain errors such as unbundled codes or charges for services not rendered. If you receive a balance bill from an out-of-network provider, remember that the No Surprises Act generally protects you from paying the difference between the provider's full charge and your insurance allowed amount for emergency care and non-emergency services at in-network facilities.