CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: Charlevoix Area Hospital

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 92507
Insurance Median: $129
Cash Discount Price: $150
vs. Medicare Baseline: 1.69x Medicare

The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at Charlevoix Area Hospital is $129. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $150. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 1.69x the Medicare baseline. Located in 14700 Lakeshore Drive, Charlevoix, MI.

Cash / Self-Pay

$150

Average discount available for prompt cash payment at this facility.

Insurance Median

$129

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: $150 (197%)

Insurance Median: $129 (169%)

Cash: $150 (197% of Medicare)

Ins. Median: $129 (169% 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.

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
UnitedHealthcare	$28 - $153	37%
Blue Cross Blue Shield	$52 - $163	68%
Mclaren Health Plan	$52 - $164	68%
Meridian	$52	68%
Priority Health	$52 - $176	68%
Aetna	$73 - $159	96%
Blue Care Network	$73 - $83	96%
Hap (Health Alliance Plan)	$73 - $141	96%
Medicare (plans)	$73 - $83	96%
Michigan Amish Medical Board	$73 - $83	96%
Molina	$73 - $89	96%
Northern Michigan Mennonite Group	$73 - $83	96%
Provider Network Of America/Hma Group Health	$103 - $150	135%
Hospice Of Michigan	$106	139%
Cigna	$107 - $176	141%
Asr Physicians Care Network	$110 - $141	144%
Nomi Health	$117 - $164	154%
Employee Benefits Logistics	$125 - $141	164%
Enterprise Group Planning Employee Benefit Plan	$141	185%
First Health/Coventry Health/Community Care Network	$141	185%
Medical Cost Savings Solution	$141	185%
Three Rivers Provider Network	$150	197%
Iba Health And Life Assurance Company	$162	213%
Cofinity	$164	215%
Preferred Medical Claim Solutions	$167	219%

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 $150.
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 Charlevoix Area 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.