CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: Boston Children's Hospital

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 92507
Insurance Median: $467
Cash Discount Price: $657
vs. Medicare Baseline: 6.13x Medicare

The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at Boston Children's Hospital is $467. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $657. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 6.13x the Medicare baseline. Located in 300 Longwood Avenue, Boston, MA.

Cash / Self-Pay

$657

Average discount available for prompt cash payment at this facility.

Insurance Median

$467

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: $657 (863%)

Insurance Median: $467 (613%)

Cash: $657 (863% of Medicare)

Ins. Median: $467 (613% 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 613% of the Medicare baseline (a markup of 513%). 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
Unicare	$255	335%
Blue Cross Blue Shield	$280 - $434	368%
Cdphp	$322 - $558	423%
Harvard Pilgrim	$334 - $444	439%
United	$393 - $549	516%
Aetna	$394 - $551	517%
Mgb/Allways	$400 - $486	525%
Tufts Public Plan	$404 - $405	531%
United Ri Nj Ny	$414	544%
Ambetter / Centene	$415	545%
Carelon Strategies/Bhs	$427	561%
UnitedHealthcare	$427 - $558	561%
Carelon/Beacon	$493	647%
Fallon	$501 - $506	658%
Health New England	$531	697%
Cigna	$558 - $593	733%
Ets/Lifetrac	$558	733%
Interlink Transplant	$558	733%
Community Health Options	$591	776%
Humana	$591	776%
Coventry/Hcvm/First Health	$604	793%
Multiplan/Phcs	$604 - $624	793%

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 $657.
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 Boston Children's Hospital 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.