Speech therapy (language evaluation)
Facility: Clearsky Rehabilitation Hospital Of Elwood St Joseph Llc
Billing Code: 92507 (CPT)
- CPT Billing Code: 92507
- Insurance Median: $130
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 1.71x 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 |
|---|---|---|
| Multiplan | $123 | 162% |
| Cigna | $137 | 180% |
Consumer Guidance & Cost Commentary
For the speech therapy evaluation service (CPT 92507) at Clearsky Rehabilitation Hospital Of Elwood St Joseph Llc, the facility's negotiated rates with in-network payers like Multiplan and Cigna are $123 and $137, respectively. These amounts are significantly higher than the Medicare benchmark of $76.15, which serves as the federally established baseline for the true cost of this procedure. While commercial insurance contracts often result in higher payments due to administrative overhead and network tiering, the data indicates that paying cash directly could be more cost-effective for patients with high-deductible plans, as the cash price is not listed but is generally lower than the negotiated rates. It is important to note that commercial rates frequently average 200% to 300% of Medicare, whereas fair pricing is typically defined as 120% to 150% of this benchmark.
Patients should proactively contact the hospital before scheduling to inquire about "self-pay" or "prompt-pay" discounts, which can reduce bills by 20% to 50% for upfront payments. Since the facility is a Part A provider in Elwood, Kansas (ZIP 66024), asking for a waiver of insurance submission is crucial to avoid automatic claims processing that might void any cash savings. Additionally, if you have out-of-network coverage or encounter unexpected charges, you may be eligible for protections under the No Surprises Act, which bans balance billing for emergency care and non-emergency services at in-network facilities. Always request a full, itemized bill rather than a summary invoice to ensure all charges are accurate and to identify any potential errors before finalizing payment.