CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: Holland Community Hospital

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 92507
Insurance Median: $174
Cash Discount Price: $171
vs. Medicare Baseline: 2.28x Medicare

The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at Holland Community Hospital is $174. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $171. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 2.28x the Medicare baseline. Located in 602 Michigan Ave, Holland, MI.

Cash / Self-Pay

$171

Average discount available for prompt cash payment at this facility.

Insurance Median

$174

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: $171 (225%)

Insurance Median: $174 (228%)

Cash: $171 (225% of Medicare)

Ins. Median: $174 (228% 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 228% of the Medicare baseline (a markup of 128%). 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
Life Circles-All Plans	$70	92%
Health Alliance Mcr Adv	$73	96%
Ph Mcr Adv	$73	96%
Va Ccn - All Plans	$73	96%
Aetna	$76 - $228	100%
Longevity Health Plan-All Plans	$79	104%
UnitedHealthcare	$90 - $285	118%
Molina Mcaid - All Plans	$91	120%
Ph Mcaid	$91	120%
Cigna	$115	151%
Priority Health - All Other Plans	$115	151%
Nomi Health - All Plans	$135	177%
Health Alliance Hmo	$166	218%
Asr - All Plans	$174	228%
Health Alliance Ahl - All Other Plans	$174	228%
Sisco Epi	$188	247%
Sisco-All Other Plans	$188	247%
Cofinity -All Plans	$200	263%
Blue Cross Blue Shield	$214	281%
Multiplan - All Plans	$248	326%
Benefit Source Inc-All Plans	$256	336%
First Health-All Plans	$256	336%
Usa Managed Care-All Plans	$256	336%
Integrated Health Plans-All Plans	$271	356%

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 $171.
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 Holland Community 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.