CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: Buffalo Hospital

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 92507
Insurance Median: $254
Cash Discount Price: $240
vs. Medicare Baseline: 3.34x Medicare

The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at Buffalo Hospital is $254. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $240. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 3.34x the Medicare baseline. Located in 303 Catlin Street, Buffalo, MN.

Cash / Self-Pay

$240

Average discount available for prompt cash payment at this facility.

Insurance Median

$254

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: $240 (315%)

Insurance Median: $254 (334%)

Cash: $240 (315% of Medicare)

Ins. Median: $254 (334% 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 334% of the Medicare baseline (a markup of 234%). 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
Medicaid / KanCare	$61	80%
South Country Health Alliance	$63	83%
Aetna	$72 - $255	95%
Medicare (plans)	$76	100%
Blue Cross Blue Shield	$79 - $522	104%
Medica	$79 - $253	104%
Ucare Pmap (A B C D E G N O S U R H)	$86	113%
Medica Health System	$160 - $266	210%
Health Partners	$252 - $317	331%
Medica Mhps	$253	332%
Healthpartners	$291	382%
UnitedHealthcare	$311	408%
Americas Ppo (Araz)(B D N O R S V)	$331	435%
Medica Ub Health (B)	$342	449%
Americas Ppo (Araz) (B D N H O R S)	$361	474%
First Health (A C E G H U B D N O R S)	$361	474%
All Other Contracted Care (A B C D E G H N O R S U)	$429	563%

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 $240.
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 Buffalo 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.