CMS Price Transparency Data
Speech therapy (language evaluation)
Facility: Mercy Health Saint Mary's
Billing Code: 92507 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 92507
- Insurance Median: $233
- Cash Discount Price: $207
- vs. Medicare Baseline: 3.06x Medicare
The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at Mercy Health Saint Mary's is $233. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $207. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 3.06x the Medicare baseline. Located in 200 Jefferson Avenue Se, Grand Rapids, MI.
Cash / Self-Pay
$207
Average discount available for prompt cash payment at this facility.
Insurance Median
$233
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: $207 (272%)
Insurance Median: $233 (306%)
Cash: $207 (272% of Medicare)
Ins. Median: $233 (306% 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 306% of the Medicare baseline (a markup of 206%). 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 |
|---|---|---|
| Access Health | $52 | 68% |
| Blue Cross Blue Shield | $62 - $154 | 81% |
| Medicaid / KanCare | $62 - $63 | 81% |
| Aetna | $72 - $200 | 95% |
| Blue Care Network Advantage | $72 | 95% |
| Medicare (plans) | $72 | 95% |
| Align Senior Care | $74 | 97% |
| Correctional Recovery | $74 | 97% |
| Hospice Faith | $74 | 97% |
| Hospice Of Holland | $74 | 97% |
| UnitedHealthcare | $76 - $319 | 100% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $83 | 109% |
| Oscar | $94 | 123% |
| Molina Marketplace | $96 | 126% |
| Vitalcore | $114 | 150% |
| Wellpath | $114 | 150% |
| Priority Health | $140 - $143 | 184% |
| Bcn Domestic | $154 | 202% |
| Blue Benefit Administrators Of Massachusetts | $154 | 202% |
| Blue Care Network | $154 | 202% |
| Blue Distinction Transplant | $154 | 202% |
| Blue Shield - Ca | $154 | 202% |
| Blue Shield - Id (Regence) | $154 | 202% |
| Blue Shield - Ny Highmark Northeastern | $154 | 202% |
| Blue Shield - Ny Highmark Western | $154 | 202% |
| Blue Shield - Pa (Highmark) | $154 | 202% |
| Blue Shield - Wa (Regence) | $154 | 202% |
| Health Choices | $154 - $243 | 202% |
| Kaiser Domestic | $154 | 202% |
| U Of M Health Plan | $163 - $243 | 214% |
| Wc Accident Fund | $174 | 228% |
| Wc Advantage | $174 | 228% |
| Wc Aig | $174 | 228% |
| Wc Allied | $174 | 228% |
| Wc Amerisure | $174 | 228% |
| Wc Amtrust | $174 | 228% |
| Wc Asu Risk Mgt | $174 | 228% |
| Wc Berkley Admin | $174 | 228% |
| Wc Broadspire | $174 | 228% |
| Wc Bunch & Associates | $174 | 228% |
| Wc Ccmsi | $174 | 228% |
| Wc Emc Insurance Company | $174 | 228% |
| Wc Esis | $174 | 228% |
| Wc Fcci | $174 | 228% |
| Wc Federated | $174 | 228% |
| Wc Gallagher Bassett | $174 | 228% |
| Wc Genex Care For Ohio | $174 | 228% |
| Wc Guard Insurance Company | $174 | 228% |
| Wc Hartford | $174 | 228% |
| Wc Liberty Mutual | $174 | 228% |
| Wc Meijers | $174 | 228% |
| Wc Michigan | $174 | 228% |
| Wc Mitchell Frankenmuth | $174 | 228% |
| Wc Pma | $174 | 228% |
| Wc Sedgwick | $174 | 228% |
| Wc Sentry | $174 | 228% |
| Wc Travelers | $174 | 228% |
| Wc Tristar | $174 | 228% |
| Wc Walmart | $174 | 228% |
| Wc Zurich | $174 | 228% |
| Nomi Health | $179 | 235% |
| Acs Benefit Services | $183 | 240% |
| Allied Benefit Systems | $183 | 240% |
| Claimchoice Adminstrators | $183 | 240% |
| Consociate | $183 | 240% |
| Cypress Benefit Administrators | $183 | 240% |
| Forest County Potawatomi | $183 | 240% |
| Health Smart | $183 | 240% |
| Healthgram | $183 | 240% |
| Healthscope | $183 | 240% |
| Secureone Preferred United Plans | $183 | 240% |
| Sisco Benefits | $183 | 240% |
| The Health Plan | $183 | 240% |
| Trustmark Small Business Benefits | $183 | 240% |
| Unified Group Services | $183 | 240% |
| Webtpa | $183 | 240% |
| Geha | $200 - $242 | 263% |
| Medical Mutual | $200 | 263% |
| Meritain | $200 | 263% |
| Preferred One | $200 | 263% |
| Asr Health Benefits | $203 | 267% |
| Hap | $203 - $247 | 267% |
| Varipro | $207 | 272% |
| Caresource | $208 | 273% |
| 1199 National Benefit Fund | $233 | 306% |
| Allied National Global Care | $233 | 306% |
| Asrm - Reliance Standard Life Insurance | $233 | 306% |
| Christian Care Ministry | $233 | 306% |
| Cigna | $233 | 306% |
| Dean Health | $233 | 306% |
| Fallon Health | $233 | 306% |
| Family Life Insurance Company | $233 | 306% |
| Ghc Scw | $233 | 306% |
| Group Pension Administrators | $233 | 306% |
| International Benefit Administrators | $233 | 306% |
| Lifetime Benefit Solutions | $233 | 306% |
| Manhattan Life | $233 | 306% |
| Medi Share | $233 | 306% |
| Multiplan | $233 | 306% |
| Mvp | $233 | 306% |
| Pai | $233 | 306% |
| Pan-American Life | $233 | 306% |
| Paramount Hmo | $233 | 306% |
| Phcs | $233 | 306% |
| Trinity Health Share | $233 | 306% |
| Acclaim | $243 | 319% |
| Administrative Concepts | $243 | 319% |
| Allegeant | $243 | 319% |
| Ameriben | $243 | 319% |
| American Family | $243 | 319% |
| American Healthcare Alliance | $243 | 319% |
| American Republic | $243 | 319% |
| Amerihealth | $243 | 319% |
| Aultcare | $243 | 319% |
| Automated Benefit Services | $243 | 319% |
| Auxiant | $243 | 319% |
| Benefit Administrative Systems,Llc | $243 | 319% |
| Boon Chapman | $243 | 319% |
| Cam Administrative Services | $243 | 319% |
| Christian Brother Services | $243 | 319% |
| Christian Brothers Holy Cross | $243 | 319% |
| Comprehensive Benefits | $243 | 319% |
| Continental Life Insurance | $243 | 319% |
| Custom Benefit Administrators | $243 | 319% |
| Employee Benefit Concepts | $243 | 319% |
| Employee Benefit Management | $243 | 319% |
| Enterprise Group Planning | $243 | 319% |
| Freedom Life Insurance Company | $243 | 319% |
| Group Administrators | $243 | 319% |
| Group Marketing Services | $243 | 319% |
| Guardian | $243 | 319% |
| Health America | $243 | 319% |
| Healthez | $243 | 319% |
| Humana | $243 - $319 | 319% |
| Insight | $243 | 319% |
| Intercare | $243 | 319% |
| Jfp Benefit Management | $243 | 319% |
| Jp Farley Corporation | $243 | 319% |
| Key Benefit Administrator | $243 | 319% |
| Liberty Union Life Assurance Co | $243 | 319% |
| Lucent Health | $243 | 319% |
| Luminare Health | $243 | 319% |
| Luminare Health (Detroit) | $243 | 319% |
| Medben | $243 | 319% |
| Medcost | $243 | 319% |
| Mutual Health Services | $243 | 319% |
| Mutual Of Omaha | $243 | 319% |
| Ncas | $243 | 319% |
| Nippon Life Ins | $243 | 319% |
| Nova | $243 | 319% |
| Painters Union Insurance Fund | $243 | 319% |
| Physicians Mutual | $243 | 319% |
| Plumbers Local 98 Insurance Fund | $243 | 319% |
| Prairie States | $243 | 319% |
| Primary Physician Care | $243 | 319% |
| Professional Benefit Administrators | $243 | 319% |
| The Loomis Company | $243 | 319% |
| Unicare | $243 | 319% |
| Us Health And Life | $243 | 319% |
| Valenz | $243 | 319% |
| Western & Southern Financial Group | $243 | 319% |
| Wps | $243 | 319% |
| Coventry | $253 | 332% |
| First Health | $253 | 332% |
| Cmh Allegan County | $319 | 419% |
| Cmh Ausable Valley | $319 | 419% |
| Cmh Barry County | $319 | 419% |
| Cmh Berrien County | $319 | 419% |
| Cmh Cass County | $319 | 419% |
| Cmh Clinton-Eaton-Ingham County | $319 | 419% |
| Cmh Kalamazoo | $319 | 419% |
| Cmh Kent County | $319 | 419% |
| Cmh Lenawee County | $319 | 419% |
| Cmh Misc | $319 | 419% |
| Cmh Monroe County | $319 | 419% |
| Cmh Montcalm County | $319 | 419% |
| Cmh Muskegon County | $319 | 419% |
| Cmh Newaygo County | $319 | 419% |
| Cmh North Country | $319 | 419% |
| Cmh Northern Lakes County | $319 | 419% |
| Cmh Ottawa County | $319 | 419% |
| Cmh Van Buren County | $319 | 419% |
| Cmh West Mi County | $319 | 419% |
| Magellan Behavioral Health | $319 | 419% |