CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: North Oaks Medical Center

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 92507
Insurance Median: $71
Cash Discount Price: $173
vs. Medicare Baseline: 0.93x Medicare

The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at North Oaks Medical Center is $71. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $173. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 0.93x the Medicare baseline. Located in 15790 Paul Vega Md Drive, Hammond, LA.

Cash / Self-Pay

$173

Average discount available for prompt cash payment at this facility.

Insurance Median

$71

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$76.15

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $76.15 (100%)

Cash / Self-Pay: $173 (227%)

Insurance Median: $71 (93%)

Cash: $173 (227% of Medicare)

Ins. Median: $71 (93% of 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Mco Hb	$33	43%
Mco Lhc	$33	43%
Medicaid / KanCare	$33	43%
UnitedHealthcare	$33 - $147	43%
Aetna	$51 - $399	67%
Humana	$51 - $352	67%
Mco Lacare Am	$51	67%
Tricare	$69 - $71	91%
Allwell	$71	93%
Blue Advantage	$71	93%
Champva	$71	93%
Healthy Blue Dual Advantage	$71	93%
Peoples Health	$71	93%
Vantage 65	$71	93%
Veterans Administration	$71	93%
Wellcare	$71	93%
Blue Cross Blue Shield	$171 - $173	225%
Verity Healthnet	$305	401%
Ppoplus Llc	$328	431%
Multiplan	$352	462%
Cigna	$371	487%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $173.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 92507.

Insurance In-Network Protection Plan

Contact your insurance company to confirm North Oaks Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 92507.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.