CMS Price Transparency Data
Speech therapy (language evaluation)
Facility: Trinity Health Oakland Hospital
Billing Code: 92507 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 92507
- Insurance Median: $314
- Cash Discount Price: $300
- vs. Medicare Baseline: 4.12x Medicare
The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at Trinity Health Oakland Hospital is $314. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $300. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 4.12x the Medicare baseline. Located in 44405 Woodward Ave, Pontiac, MI.
Cash / Self-Pay
$300
Average discount available for prompt cash payment at this facility.
Insurance Median
$314
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: $300 (394%)
Insurance Median: $314 (412%)
Cash: $300 (394% of Medicare)
Ins. Median: $314 (412% 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 412% of the Medicare baseline (a markup of 312%). 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 |
|---|---|---|
| Medicaid / KanCare | $61 - $62 | 80% |
| Blue Cross Blue Shield | $62 - $165 | 81% |
| Aetna | $74 - $289 | 97% |
| Blue Care Network Advantage | $74 | 97% |
| Medicare (plans) | $74 - $76 | 97% |
| Align Senior Care | $76 | 100% |
| Hospice Advantage | $76 | 100% |
| UnitedHealthcare | $78 - $346 | 102% |
| Cca - Zing Health | $80 | 105% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $85 | 112% |
| Molina Marketplace | $98 | 129% |
| Priority Health | $104 - $116 | 137% |
| Health Cost Solutions | $117 | 154% |
| Vitalcore | $117 | 154% |
| Wellpath | $117 | 154% |
| Wc Accident Fund | $140 | 184% |
| Wc Advantage | $140 | 184% |
| Wc Aig | $140 | 184% |
| Wc Allied | $140 | 184% |
| Wc Amerisure | $140 | 184% |
| Wc Amtrust | $140 | 184% |
| Wc Asu Risk Mgt | $140 | 184% |
| Wc Berkley Admin | $140 | 184% |
| Wc Broadspire | $140 | 184% |
| Wc Bunch & Associates | $140 | 184% |
| Wc Ccmsi | $140 | 184% |
| Wc Emc Insurance Company | $140 | 184% |
| Wc Esis | $140 | 184% |
| Wc Fcci | $140 | 184% |
| Wc Federated | $140 | 184% |
| Wc Gallagher Bassett | $140 | 184% |
| Wc Genex Care For Ohio | $140 | 184% |
| Wc Guard Insurance Company | $140 | 184% |
| Wc Hartford | $140 | 184% |
| Wc Liberty Mutual | $140 | 184% |
| Wc Meijers | $140 | 184% |
| Wc Michigan | $140 | 184% |
| Wc Mitchell Frankenmuth | $140 | 184% |
| Wc Pma | $140 | 184% |
| Wc Sedgwick | $140 | 184% |
| Wc Sentry | $140 | 184% |
| Wc Travelers | $140 | 184% |
| Wc Tristar | $140 | 184% |
| Wc Walmart | $140 | 184% |
| Wc Zurich | $140 | 184% |
| U Of M Health Plan | $163 | 214% |
| Bcn Domestic | $165 | 217% |
| Blue Benefit Administrators Of Massachusetts | $165 | 217% |
| Blue Care Network | $165 | 217% |
| Blue Distinction Transplant | $165 | 217% |
| Blue Shield - Ca | $165 | 217% |
| Blue Shield - Id (Regence) | $165 | 217% |
| Blue Shield - Ny Highmark Northeastern | $165 | 217% |
| Blue Shield - Ny Highmark Western | $165 | 217% |
| Blue Shield - Pa (Highmark) | $165 | 217% |
| Blue Shield - Wa (Regence) | $165 | 217% |
| Health Choices | $165 - $339 | 217% |
| Kaiser Domestic | $165 | 217% |
| Employee Benefit Logistic | $170 | 223% |
| Asr Health Benefits | $184 | 242% |
| Caresource | $184 | 242% |
| Hap | $184 - $336 | 242% |
| Varipro | $184 | 242% |
| Acs Benefit Services | $203 | 267% |
| Allied Benefit Systems | $203 | 267% |
| Claimchoice Adminstrators | $203 | 267% |
| Consociate | $203 | 267% |
| Cypress Benefit Administrators | $203 | 267% |
| Forest County Potawatomi | $203 | 267% |
| Health Smart | $203 | 267% |
| Healthgram | $203 | 267% |
| Healthscope | $203 | 267% |
| Secureone Preferred United Plans | $203 | 267% |
| Sisco Benefits | $203 | 267% |
| The Health Plan | $203 | 267% |
| Trustmark Small Business Benefits | $203 | 267% |
| Unified Group Services | $203 | 267% |
| Webtpa | $203 | 267% |
| Mclaren Health | $222 - $242 | 292% |
| Carelon Behavioral Health | $231 | 303% |
| Magellan Behavioral Health | $277 | 364% |
| Geha | $289 - $346 | 380% |
| Medical Mutual | $289 | 380% |
| Meritain | $289 | 380% |
| 1199 National Benefit Fund | $314 | 412% |
| Allied National Global Care | $314 | 412% |
| Asrm - Reliance Standard Life Insurance | $314 | 412% |
| Christian Care Ministry | $314 | 412% |
| Dean Health | $314 | 412% |
| Fallon Health | $314 | 412% |
| Family Life Insurance Company | $314 | 412% |
| Ghc Scw | $314 | 412% |
| Group Pension Administrators | $314 | 412% |
| International Benefit Administrators | $314 | 412% |
| Lifetime Benefit Solutions | $314 | 412% |
| Manhattan Life | $314 | 412% |
| Medi Share | $314 | 412% |
| Multiplan | $314 | 412% |
| Mvp | $314 | 412% |
| Pai | $314 | 412% |
| Pan-American Life | $314 | 412% |
| Paramount Hmo | $314 | 412% |
| Phcs | $314 | 412% |
| Trinity Health Share | $314 | 412% |
| Health Partners | $336 | 441% |
| Tufts Health Plan | $336 | 441% |
| Access Health | $339 | 445% |
| Acclaim | $339 | 445% |
| Administrative Concepts | $339 | 445% |
| Allegeant | $339 | 445% |
| Ameriben | $339 | 445% |
| American Family | $339 | 445% |
| American Healthcare Alliance | $339 | 445% |
| American National | $339 | 445% |
| American Republic | $339 | 445% |
| Amerihealth | $339 | 445% |
| Aultcare | $339 | 445% |
| Automated Benefit Services | $339 | 445% |
| Auxiant | $339 | 445% |
| Benefit Administrative Systems,Llc | $339 | 445% |
| Boon Chapman | $339 | 445% |
| Cam Administrative Services | $339 | 445% |
| Christian Brother Services | $339 | 445% |
| Christian Brothers Holy Cross | $339 | 445% |
| Comprehensive Benefits | $339 | 445% |
| Continental Life Insurance | $339 | 445% |
| Custom Benefit Administrators | $339 | 445% |
| Employee Benefit Concepts | $339 | 445% |
| Employee Benefit Management | $339 | 445% |
| Enterprise Group Planning | $339 | 445% |
| Freedom Life Insurance Company | $339 | 445% |
| Group Administrators | $339 | 445% |
| Group Marketing Services | $339 | 445% |
| Guardian | $339 | 445% |
| Health America | $339 | 445% |
| Healthcare Management Admin | $339 | 445% |
| Healthez | $339 | 445% |
| Humana | $339 | 445% |
| Insight | $339 | 445% |
| Intercare | $339 | 445% |
| Jfp Benefit Management | $339 | 445% |
| Jp Farley Corporation | $339 | 445% |
| Key Benefit Administrator | $339 | 445% |
| Liberty Union Life Assurance Co | $339 | 445% |
| Lucent Health | $339 | 445% |
| Luminare Health | $339 | 445% |
| Luminare Health (Detroit) | $339 | 445% |
| Magnacare | $339 | 445% |
| Medben | $339 | 445% |
| Medcost | $339 | 445% |
| Mutual Health Services | $339 | 445% |
| Mutual Of Omaha | $339 | 445% |
| Ncas | $339 | 445% |
| Nippon Life Ins | $339 | 445% |
| Nova | $339 | 445% |
| Painters Union Insurance Fund | $339 | 445% |
| Physicians Mutual | $339 | 445% |
| Plumbers Local 98 Insurance Fund | $339 | 445% |
| Prairie States | $339 | 445% |
| Preferred One | $339 | 445% |
| Primary Physician Care | $339 | 445% |
| Professional Benefit Administrators | $339 | 445% |
| Siho Insurance Services | $339 | 445% |
| The Loomis Company | $339 | 445% |
| Unicare | $339 | 445% |
| Us Health And Life | $339 | 445% |
| Valenz | $339 | 445% |
| Western & Southern Financial Group | $339 | 445% |
| Wps | $339 | 445% |
| Cigna | $342 | 449% |
| Coventry | $348 | 457% |
| First Health | $348 | 457% |
| Prime Health Services | $370 | 486% |
| Three Rivers Provider Network | $416 | 546% |
| Cmh Detroit Wayne Integrated Health Network | $462 | 607% |
| Cmh Lenawee County | $462 | 607% |
| Cmh Livingston County | $462 | 607% |
| Cmh Misc | $462 | 607% |
| Cmh Monroe County | $462 | 607% |
| Cmh Oakland County | $462 | 607% |
| Cmh Washtenaw County | $462 | 607% |