CMS Price Transparency Data
Speech therapy (language evaluation)
Facility: Trinity Health Muskegon Hospital
Billing Code: 92507 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 92507
- Insurance Median: $239
- Cash Discount Price: $207
- vs. Medicare Baseline: 3.14x Medicare
The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at Trinity Health Muskegon Hospital is $239. 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 3.14x the Medicare baseline. Located in 1500 E Sherman Blvd, Muskegon, MI.
Cash / Self-Pay
$207
Average discount available for prompt cash payment at this facility.
Insurance Median
$239
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: $239 (314%)
Cash: $207 (272% of Medicare)
Ins. Median: $239 (314% 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 314% of the Medicare baseline (a markup of 214%). 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.
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 |
|---|---|---|
| Access Health | $52 | 68% |
| Blue Cross Blue Shield | $62 - $156 | 81% |
| Medicaid / KanCare | $62 - $63 | 81% |
| Aetna | $72 - $216 | 95% |
| Blue Care Network Advantage | $72 | 95% |
| Medicare (plans) | $72 | 95% |
| Align Senior Care | $74 | 97% |
| Correctional Recovery | $74 | 97% |
| Heartland Hospice | $74 | 97% |
| Hospice Harbor Hospice | $74 | 97% |
| UnitedHealthcare | $76 - $281 | 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 | $120 - $135 | 158% |
| Bcn Domestic | $156 | 205% |
| Blue Benefit Administrators Of Massachusetts | $156 | 205% |
| Blue Care Network | $156 | 205% |
| Blue Distinction Transplant | $156 | 205% |
| Blue Shield - Ca | $156 | 205% |
| Blue Shield - Id (Regence) | $156 | 205% |
| Blue Shield - Ny Highmark Northeastern | $156 | 205% |
| Blue Shield - Ny Highmark Western | $156 | 205% |
| Blue Shield - Pa (Highmark) | $156 | 205% |
| Blue Shield - Wa (Regence) | $156 | 205% |
| Health Choices | $156 - $251 | 205% |
| Kaiser Domestic | $156 | 205% |
| U Of M Health Plan | $163 - $251 | 214% |
| Acs Benefit Services | $166 | 218% |
| Allied Benefit Systems | $166 | 218% |
| Claimchoice Adminstrators | $166 | 218% |
| Consociate | $166 | 218% |
| Cypress Benefit Administrators | $166 | 218% |
| Forest County Potawatomi | $166 | 218% |
| Health Smart | $166 | 218% |
| Healthgram | $166 | 218% |
| Healthscope | $166 | 218% |
| Preferred One | $166 | 218% |
| Secureone Preferred United Plans | $166 | 218% |
| Sisco Benefits | $166 | 218% |
| The Health Plan | $166 | 218% |
| Trustmark Small Business Benefits | $166 | 218% |
| Unified Group Services | $166 | 218% |
| Webtpa | $166 | 218% |
| Asr Health Benefits | $169 | 222% |
| Hap | $169 - $253 | 222% |
| Wc Accident Fund | $170 | 223% |
| Wc Advantage | $170 | 223% |
| Wc Aig | $170 | 223% |
| Wc Allied | $170 | 223% |
| Wc Amerisure | $170 | 223% |
| Wc Amtrust | $170 | 223% |
| Wc Asu Risk Mgt | $170 | 223% |
| Wc Berkley Admin | $170 | 223% |
| Wc Broadspire | $170 | 223% |
| Wc Bunch & Associates | $170 | 223% |
| Wc Ccmsi | $170 | 223% |
| Wc Emc Insurance Company | $170 | 223% |
| Wc Esis | $170 | 223% |
| Wc Fcci | $170 | 223% |
| Wc Federated | $170 | 223% |
| Wc Gallagher Bassett | $170 | 223% |
| Wc Genex Care For Ohio | $170 | 223% |
| Wc Guard Insurance Company | $170 | 223% |
| Wc Hartford | $170 | 223% |
| Wc Liberty Mutual | $170 | 223% |
| Wc Meijers | $170 | 223% |
| Wc Michigan | $170 | 223% |
| Wc Mitchell Frankenmuth | $170 | 223% |
| Wc Pma | $170 | 223% |
| Wc Sedgwick | $170 | 223% |
| Wc Sentry | $170 | 223% |
| Wc Travelers | $170 | 223% |
| Wc Tristar | $170 | 223% |
| Wc Walmart | $170 | 223% |
| Wc Zurich | $170 | 223% |
| Hospice Of Michigan | $175 | 230% |
| Nomi Health | $179 | 235% |
| Varipro | $185 | 243% |
| Caresource | $201 | 264% |
| Cigna | $201 | 264% |
| Geha | $216 - $281 | 284% |
| Meritain | $216 | 284% |
| 1199 National Benefit Fund | $239 | 314% |
| Allied National Global Care | $239 | 314% |
| Asrm - Reliance Standard Life Insurance | $239 | 314% |
| Christian Care Ministry | $239 | 314% |
| Dean Health | $239 | 314% |
| Fallon Health | $239 | 314% |
| Family Life Insurance Company | $239 | 314% |
| Ghc Scw | $239 | 314% |
| Group Pension Administrators | $239 | 314% |
| International Benefit Administrators | $239 | 314% |
| Lifetime Benefit Solutions | $239 | 314% |
| Manhattan Life | $239 | 314% |
| Medi Share | $239 | 314% |
| Multiplan | $239 | 314% |
| Mvp | $239 | 314% |
| Pai | $239 | 314% |
| Pan-American Life | $239 | 314% |
| Paramount Hmo | $239 | 314% |
| Phcs | $239 | 314% |
| Trinity Health Share | $239 | 314% |
| Acclaim | $251 | 330% |
| Administrative Concepts | $251 | 330% |
| Allegeant | $251 | 330% |
| Ameriben | $251 | 330% |
| American Family | $251 | 330% |
| American Healthcare Alliance | $251 | 330% |
| American Republic | $251 | 330% |
| Amerihealth | $251 | 330% |
| Aultcare | $251 | 330% |
| Automated Benefit Services | $251 | 330% |
| Auxiant | $251 | 330% |
| Benefit Administrative Systems,Llc | $251 | 330% |
| Boon Chapman | $251 | 330% |
| Cam Administrative Services | $251 | 330% |
| Christian Brother Services | $251 | 330% |
| Christian Brothers Holy Cross | $251 | 330% |
| Comprehensive Benefits | $251 | 330% |
| Continental Life Insurance | $251 | 330% |
| Custom Benefit Administrators | $251 | 330% |
| Employee Benefit Concepts | $251 | 330% |
| Employee Benefit Management | $251 | 330% |
| Enterprise Group Planning | $251 | 330% |
| Freedom Life Insurance Company | $251 | 330% |
| Group Administrators | $251 | 330% |
| Group Marketing Services | $251 | 330% |
| Guardian | $251 | 330% |
| Health America | $251 | 330% |
| Healthez | $251 | 330% |
| Humana | $251 | 330% |
| Insight | $251 | 330% |
| Intercare | $251 | 330% |
| Jfp Benefit Management | $251 | 330% |
| Jp Farley Corporation | $251 | 330% |
| Key Benefit Administrator | $251 | 330% |
| Liberty Union Life Assurance Co | $251 | 330% |
| Lucent Health | $251 | 330% |
| Luminare Health | $251 | 330% |
| Luminare Health (Detroit) | $251 | 330% |
| Medben | $251 | 330% |
| Medcost | $251 | 330% |
| Medical Mutual | $251 | 330% |
| Mutual Health Services | $251 | 330% |
| Mutual Of Omaha | $251 | 330% |
| Ncas | $251 | 330% |
| Nippon Life Ins | $251 | 330% |
| Nova | $251 | 330% |
| Painters Union Insurance Fund | $251 | 330% |
| Physicians Mutual | $251 | 330% |
| Plumbers Local 98 Insurance Fund | $251 | 330% |
| Prairie States | $251 | 330% |
| Primary Physician Care | $251 | 330% |
| Professional Benefit Administrators | $251 | 330% |
| The Loomis Company | $251 | 330% |
| Unicare | $251 | 330% |
| Us Health And Life | $251 | 330% |
| Valenz | $251 | 330% |
| Western & Southern Financial Group | $251 | 330% |
| Wps | $251 | 330% |
| First Health | $262 | 344% |
| Barinet | $319 | 419% |
| Cmh Allegan County | $319 | 419% |
| Cmh Barry County | $319 | 419% |
| Cmh Berrien County | $319 | 419% |
| Cmh Cass County | $319 | 419% |
| Cmh Kalamazoo | $319 | 419% |
| Cmh Kent County | $319 | 419% |
| Cmh Misc | $319 | 419% |
| Cmh Muskegon 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% |