CMS Price Transparency Data
Speech therapy (language evaluation)
Facility: Mercy Health Lakeshore Campus
Billing Code: 92507 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 92507
- Insurance Median: $274
- Cash Discount Price: $207
- vs. Medicare Baseline: 3.60x Medicare
The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at Mercy Health Lakeshore Campus is $274. 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 3.60x the Medicare baseline. Located in 72 South State Street, Shelby, MI.
Cash / Self-Pay
$207
Average discount available for prompt cash payment at this facility.
Insurance Median
$274
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: $274 (360%)
Cash: $207 (272% of Medicare)
Ins. Median: $274 (360% 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 360% of the Medicare baseline (a markup of 260%). 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 | $56 | 74% |
| Medicaid / KanCare | $61 - $62 | 80% |
| Blue Cross Blue Shield | $62 - $273 | 81% |
| Blue Care Network Advantage | $78 | 102% |
| Medicare (plans) | $78 | 102% |
| Aetna | $80 - $254 | 105% |
| Align Senior Care | $80 | 105% |
| Correctional Recovery | $80 | 105% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $90 | 118% |
| Oscar | $98 | 129% |
| Vitalcore | $106 | 139% |
| UnitedHealthcare | $112 - $287 | 147% |
| Wellpath | $114 | 150% |
| Molina Marketplace | $133 | 175% |
| U Of M Health Plan | $163 - $286 | 214% |
| Hospice Of Michigan | $175 | 230% |
| Nomi Health | $179 | 235% |
| Hap | $239 - $293 | 314% |
| Wc Accident Fund | $252 | 331% |
| Wc Advantage | $252 | 331% |
| Wc Aig | $252 | 331% |
| Wc Allied | $252 | 331% |
| Wc Amerisure | $252 | 331% |
| Wc Amtrust | $252 | 331% |
| Wc Asu Risk Mgt | $252 | 331% |
| Wc Berkley Admin | $252 | 331% |
| Wc Broadspire | $252 | 331% |
| Wc Bunch & Associates | $252 | 331% |
| Wc Ccmsi | $252 | 331% |
| Wc Emc Insurance Company | $252 | 331% |
| Wc Esis | $252 | 331% |
| Wc Fcci | $252 | 331% |
| Wc Federated | $252 | 331% |
| Wc Gallagher Bassett | $252 | 331% |
| Wc Genex Care For Ohio | $252 | 331% |
| Wc Guard Insurance Company | $252 | 331% |
| Wc Hartford | $252 | 331% |
| Wc Liberty Mutual | $252 | 331% |
| Wc Meijers | $252 | 331% |
| Wc Michigan | $252 | 331% |
| Wc Mitchell Frankenmuth | $252 | 331% |
| Wc Pma | $252 | 331% |
| Wc Sedgwick | $252 | 331% |
| Wc Sentry | $252 | 331% |
| Wc Travelers | $252 | 331% |
| Wc Tristar | $252 | 331% |
| Wc Walmart | $252 | 331% |
| Wc Zurich | $252 | 331% |
| Geha | $254 - $287 | 334% |
| Meritain | $254 | 334% |
| Asr Health Benefits | $266 | 349% |
| Bcn Domestic | $273 | 359% |
| Blue Benefit Administrators Of Massachusetts | $273 | 359% |
| Blue Care Network | $273 | 359% |
| Blue Distinction Transplant | $273 | 359% |
| Blue Shield - Ca | $273 | 359% |
| Blue Shield - Id (Regence) | $273 | 359% |
| Blue Shield - Ny Highmark Northeastern | $273 | 359% |
| Blue Shield - Ny Highmark Western | $273 | 359% |
| Blue Shield - Pa (Highmark) | $273 | 359% |
| Blue Shield - Wa (Regence) | $273 | 359% |
| Health Choices | $273 - $286 | 359% |
| Kaiser Domestic | $273 | 359% |
| 1199 National Benefit Fund | $274 | 360% |
| Allied National Global Care | $274 | 360% |
| Asrm - Reliance Standard Life Insurance | $274 | 360% |
| Christian Care Ministry | $274 | 360% |
| Dean Health | $274 | 360% |
| Fallon Health | $274 | 360% |
| Family Life Insurance Company | $274 | 360% |
| Ghc Scw | $274 | 360% |
| Group Pension Administrators | $274 | 360% |
| International Benefit Administrators | $274 | 360% |
| Lifetime Benefit Solutions | $274 | 360% |
| Manhattan Life | $274 | 360% |
| Medi Share | $274 | 360% |
| Multiplan | $274 | 360% |
| Mvp | $274 | 360% |
| Pai | $274 | 360% |
| Pan-American Life | $274 | 360% |
| Paramount Hmo | $274 | 360% |
| Phcs | $274 | 360% |
| Trinity Health Share | $274 | 360% |
| Cigna | $277 | 364% |
| Caresource | $285 | 374% |
| Acclaim | $286 | 376% |
| Administrative Concepts | $286 | 376% |
| Allegeant | $286 | 376% |
| Allied Benefit Systems | $286 | 376% |
| Ameriben | $286 | 376% |
| American Family | $286 | 376% |
| American Healthcare Alliance | $286 | 376% |
| American Republic | $286 | 376% |
| Amerihealth | $286 | 376% |
| Aultcare | $286 | 376% |
| Automated Benefit Services | $286 | 376% |
| Auxiant | $286 | 376% |
| Benefit Administrative Systems,Llc | $286 | 376% |
| Boon Chapman | $286 | 376% |
| Cam Administrative Services | $286 | 376% |
| Christian Brother Services | $286 | 376% |
| Christian Brothers Holy Cross | $286 | 376% |
| Claimchoice Adminstrators | $286 | 376% |
| Comprehensive Benefits | $286 | 376% |
| Consociate | $286 | 376% |
| Continental Life Insurance | $286 | 376% |
| Custom Benefit Administrators | $286 | 376% |
| Cypress Benefit Administrators | $286 | 376% |
| Employee Benefit Concepts | $286 | 376% |
| Employee Benefit Management | $286 | 376% |
| Enterprise Group Planning | $286 | 376% |
| Forest County Potawatomi | $286 | 376% |
| Freedom Life Insurance Company | $286 | 376% |
| Group Administrators | $286 | 376% |
| Group Marketing Services | $286 | 376% |
| Guardian | $286 | 376% |
| Health America | $286 | 376% |
| Health Smart | $286 | 376% |
| Healthez | $286 | 376% |
| Healthgram | $286 | 376% |
| Healthscope | $286 | 376% |
| Humana | $286 | 376% |
| Insight | $286 | 376% |
| Intercare | $286 | 376% |
| Jfp Benefit Management | $286 | 376% |
| Jp Farley Corporation | $286 | 376% |
| Key Benefit Administrator | $286 | 376% |
| Liberty Union Life Assurance Co | $286 | 376% |
| Lucent Health | $286 | 376% |
| Luminare Health | $286 | 376% |
| Luminare Health (Detroit) | $286 | 376% |
| Medben | $286 | 376% |
| Medcost | $286 | 376% |
| Medical Mutual | $286 | 376% |
| Mutual Health Services | $286 | 376% |
| Mutual Of Omaha | $286 | 376% |
| Ncas | $286 | 376% |
| Nippon Life Ins | $286 | 376% |
| Nova | $286 | 376% |
| Painters Union Insurance Fund | $286 | 376% |
| Physicians Mutual | $286 | 376% |
| Plumbers Local 98 Insurance Fund | $286 | 376% |
| Prairie States | $286 | 376% |
| Primary Physician Care | $286 | 376% |
| Professional Benefit Administrators | $286 | 376% |
| Secureone Preferred United Plans | $286 | 376% |
| The Loomis Company | $286 | 376% |
| Trustmark Small Business Benefits | $286 | 376% |
| Unicare | $286 | 376% |
| Unified Group Services | $286 | 376% |
| Us Health And Life | $286 | 376% |
| Valenz | $286 | 376% |
| Varipro | $286 - $293 | 376% |
| Western & Southern Financial Group | $286 | 376% |
| Wps | $286 | 376% |
| Priority Health | $287 | 377% |
| First Health | $288 | 378% |