CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: UMass Memorial Healthalliance Hospitals

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 92507
Insurance Median: $165
Cash Discount Price: $448
vs. Medicare Baseline: 2.17x Medicare

The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at UMass Memorial Healthalliance Hospitals is $165. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $448. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 2.17x the Medicare baseline. Located in 60 Hospital Road, Leominster, MA.

Cash / Self-Pay

$448

Average discount available for prompt cash payment at this facility.

Insurance Median

$165

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: $448 (588%)

Insurance Median: $165 (217%)

Cash: $448 (588% of Medicare)

Ins. Median: $165 (217% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 217% of the Medicare baseline (a markup of 117%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Workers Compensation [20501]	$57	75%
Champva [11001]	$59	77%
Cigna	$78 - $175	102%
Correctional Care [11003]	$78 - $124	102%
Institution [10406]	$78 - $237	102%
Medicare (plans)	$78	102%
Tufts Dual [10111]	$78	102%
Tufts Us Family [11203]	$78	102%
Blue Cross Blue Shield	$81 - $214	106%
Aetna	$82 - $293	108%
Fallon Mcr Supp [20202]	$82	108%
Tufts Mcr [10112]	$82	108%
UnitedHealthcare	$82 - $448	108%
Commonwealth Care Mcr [10115]	$83	109%
Harvard Pilgrim Mcr [10106]	$83	109%
Mgb Mcr [10124]	$83	109%
Senior Whole Health [10110]	$84	110%
Medicaid / KanCare	$106 - $233	139%
Tufts [11201]	$160	210%
Wellpoint [11112]	$170	223%
Harvard Pilgrim [10701]	$208 - $249	273%
Hne [11108]	$250	328%
Hsno/Free Care [10801]	$294	386%
First Health Network [11120]	$336	441%
Multiplan [11109]	$336	441%
Fallon Connectorcare [10503]	$358	470%
Connecticare [11105]	$448	588%
Fallon Carelon Hlth [28]	$448	588%
Fallon Mcaid Carelon Hlth [29]	$448	588%
Grants [20507]	$448	588%

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 $448.
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 UMass Memorial Healthalliance Hospitals 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.