CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: Garrett Regional Medical Center

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 92507
  • Insurance Median: $159
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 2.09x Medicare
The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at Garrett Regional Medical Center is $159. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 2.09x the Medicare baseline. Located in 251 North Fourth Street, Oakland, MD.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$159

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%)
Insurance Median: $159 (209%)
Ins. Median: $159 (209% 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 209% of the Medicare baseline (a markup of 109%). 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.

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Commercial Insurance Negotiated Rates

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

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Caresource Wv $43 - $377 56%
Aetna $44 - $418 58%
Carefirst D-Snp $44 - $386 58%
Carefirst Ppo $44 - $386 58%
Humana $44 - $386 58%
Medicare (plans) $44 - $386 58%
Provider Partners $44 - $386 58%
Senior Advantage $44 - $386 58%
United Mine Workers Of America $44 - $418 58%
UnitedHealthcare $44 - $418 58%
Amerigroup $45 - $395 59%
Carefirst Community Health Plan $45 - $395 59%
Coventry $45 - $395 59%
Highmark Health Options Wv $45 - $395 59%
Maryland Physicians Care $45 - $395 59%
The Health Plan Of Wv $45 - $395 59%
Wellpoint Wv $45 - $395 59%
Multiplan $46 - $398 60%
Alliance Coal $48 - $418 63%
American Correctional Healthcare $48 - $418 63%
Carefirst Commercial $48 - $418 63%
Cigna $48 - $418 63%
First Health $48 - $418 63%
John Hopkins Healthcare $48 - $418 63%
Peak Commercial $48 - $418 63%
Stratose/ 4 Most $48 - $418 63%
The Health Plan $48 - $418 63%
The Health Plan Commercial $48 - $418 63%
Upmc Commercial $48 - $414 63%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 251 North Fourth Street, Oakland, MD 21550
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals