CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: Essentia Health St Mary's Medical Center

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 92507
  • Insurance Median: $149
  • Cash Discount Price: $187
  • vs. Medicare Baseline: 1.96x Medicare
The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at Essentia Health St Mary's Medical Center is $149. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $187. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 1.96x the Medicare baseline. Located in 402 East Second Street, Duluth, MN.
Cash / Self-Pay
$187

Average discount available for prompt cash payment at this facility.

Insurance Median
$149

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: $187 (246%)
Insurance Median: $149 (196%)
Cash: $187 (246% of Medicare)
Ins. Median: $149 (196% 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.

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
Advocare/Security Health $75 98%
Blue Cross Blue Shield $75 - $360 98%
Freedom Blue Ppo $75 98%
Healthpartners Care Msho / Mcr Adv $75 98%
Imcare Msho (Ref Req) $75 98%
Imcare Msho Pcc Prime $75 98%
Imcare Msho Ref Req $75 98%
Itasca Med Care $75 98%
Medica Advantage Solutions $75 98%
Medica Msho/Dual Solutions $75 98%
Medica Prime Solution Group $75 98%
Medicare (plans) $75 98%
Nd Va Administration $75 98%
Platinum Blue / Vantage Blue $75 98%
Primewest Msho $75 98%
Secure Blue Msho $75 98%
Ubh Cost Plan $75 98%
Ubh Msho $75 98%
Ucare Msho $75 98%
UnitedHealthcare $75 - $208 98%
Primewest $76 100%
Medica Access $94 123%
Healthpartners Care Pmap $113 148%
Sanford Health Plan $122 - $157 160%
Blue Plus Pmap Pcc Prime $125 - $142 164%
Medica $157 - $161 206%
Medica Uplan $157 206%
Healthpartners $170 - $203 223%
Medica Choice $174 228%
Ucare $187 246%
Cigna $203 267%
Healthpartners Pcc Prime $203 267%
Wea $204 - $219 268%
Security Health $219 288%
America'S Ppo $220 289%
Wps $236 - $239 310%
Aetna $241 316%
Healthscope Benefits $241 316%
Healtheos $244 320%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 402 East Second Street, Duluth, MN 55805
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals