Speech therapy (language evaluation)
Facility: Children'S Mercy South
Billing Code: 92507 (CPT)
- CPT Billing Code: 92507
- Insurance Median: $294
- Cash Discount Price: $216
- vs. Medicare Baseline: 3.86x 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 386% of the Medicare baseline (a markup of 286%). 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 | $66 - $303 | 87% |
| Healthy Blue | $86 - $202 | 113% |
| Medicaid / KanCare | $90 | 118% |
| Home State Health | $177 | 232% |
| Blue Cross Blue Shield | $185 - $334 | 243% |
| Cigna | $216 - $313 | 284% |
| Medica | $263 | 345% |
| Aetna | $271 - $307 | 356% |
| Wppa Providrs Care | $293 | 385% |
| Nebraska Furniture Mart | $293 | 385% |
| Orscheln | $293 | 385% |
| Wellfit/Centrus | $293 | 385% |
| Centivo | $293 | 385% |
| Health Midwest Comprehensive Care | $294 | 386% |
| Quiktrip | $294 | 386% |
| Humana | $300 | 394% |
| Coventry Health Care Of Kansas | $334 | 439% |
| Coxhealth Network | $334 | 439% |
| Mercy Health | $338 | 444% |
| Multiplan | $343 | 450% |
| American Healthcare Alliance | $383 | 503% |
| Healthlink | $397 | 521% |
| National Preferred Provider Network | $406 | 533% |
Consumer Guidance & Cost Commentary
For the speech therapy language evaluation service (CPT 92507) at Children's Mercy South in Overland Park, KS, the facility's cash median rate of $216.00 is notably lower than the state average of $294.00 and the negotiated rate of $294.00. While commercial payers like UnitedHealthcare and Healthy Blue have negotiated rates ranging from $66 to $303, the cash price remains the most affordable option for patients without insurance. This aligns with the principle that cash-pay can sometimes be cheaper for those with high-deductible plans if the insurance negotiated rate exceeds the cash price, as seen here where the cash rate is significantly below the median negotiated amount of $294.00.
Patients should verify their specific plan details before scheduling, as the facility offers a cash median of $216.00 which is well below the Medicare benchmark of $76.15 when adjusted for local costs, though the gross charge of $451.00 serves as the inflated list price. It is important to note that while the No Surprises Act protects against balance billing for out-of-network providers at in-network facilities, patients should still request a "self-pay" or "prompt-pay" discount upfront to avoid being billed the full gross amount. Since over 80% of hospital bills contain errors, consumers are advised to request a detailed, itemized bill before making any payments to ensure all charges are accurate and to identify any unbundled codes or services not rendered.