CMS Price Transparency Data
Speech therapy (language evaluation)
Facility: Mercy Hospital Joplin
Billing Code: 92507 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 92507
- Insurance Median: $192
- Cash Discount Price: $231
- vs. Medicare Baseline: 2.52x Medicare
The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at Mercy Hospital Joplin is $192. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $231. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 2.52x the Medicare baseline. Located in 100 Mercy Way, Joplin, MO.
Cash / Self-Pay
$231
Average discount available for prompt cash payment at this facility.
Insurance Median
$192
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: $231 (303%)
Insurance Median: $192 (252%)
Cash: $231 (303% of Medicare)
Ins. Median: $192 (252% 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 252% of the Medicare baseline (a markup of 152%). 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 |
|---|---|---|
| Medicaid / KanCare | $22 - $119 | 29% |
| Ambetter / Centene | $51 - $117 | 67% |
| Home State Health Plan Contracted [320187] | $51 - $117 | 67% |
| Novasys Contracted [320285] | $51 - $117 | 67% |
| Humana | $54 - $125 | 71% |
| Point C Contracted [320238] | $63 - $334 | 83% |
| Medica Contracted [320239] | $66 - $152 | 87% |
| Aetna | $68 - $118 | 89% |
| Blue Cross Blue Shield | $69 - $304 | 91% |
| Centivo Contracted [320505] | $69 | 91% |
| Champva [20065] | $69 | 91% |
| Cherokee Nation Health Serv Contracted [320066] | $69 | 91% |
| Cigna | $69 - $321 | 91% |
| Cross Timbers Hospice [20098] | $69 | 91% |
| Dept Of Veteran Affairs Contracted [320106] | $69 | 91% |
| Elara Caring Aspire Hospice [20433] | $69 | 91% |
| Globalhealth Contracted [320145] | $69 | 91% |
| Halo Hcr Inc Hospice Contracted [320432] | $69 | 91% |
| Halo Hcr Inc Hospice [20432] | $69 | 91% |
| Indian Health Service Contracted [320198] | $69 - $271 | 91% |
| Kindful Hospice Contracted [320434] | $69 | 91% |
| Kindful Hospice [20434] | $69 | 91% |
| Medicare (plans) | $69 - $74 | 91% |
| Mercy Hospice Okc [20252] | $69 | 91% |
| Mercy Mgd Behavioral Health Contracted [320259] | $69 | 91% |
| Pace Of The Ozarks Contracted [320518] | $69 | 91% |
| Provider Partners Health Plans Contracted [320450] | $69 | 91% |
| Qual Choice Contracted [320325] | $69 | 91% |
| Tricare | $69 | 91% |
| UnitedHealthcare | $69 - $171 | 91% |
| United Medical Resources Contracted [320454] | $74 - $198 | 97% |
| Benefit Management Contracted [320052] | $78 - $179 | 102% |
| Health Systems Inc Contracted [320174] | $78 - $179 | 102% |
| Insurance System Inc Contracted [320465] | $78 - $179 | 102% |
| Administrative Payor Contracted [320005] | $81 - $188 | 106% |
| Healthscope Contracted [320182] | $87 | 114% |
| Mercy Benefit Admin Contracted [320251] | $90 - $250 | 118% |
| Aither Health Contracted [320449] | $103 - $238 | 135% |
| Auxiant Contracted [320462] | $103 - $271 | 135% |
| Ebms Contracted [320493] | $103 - $238 | 135% |
| Edison Health Solutions Contracted [320502] | $103 - $238 | 135% |
| Healthlink Contracted [320179] | $103 - $334 | 135% |
| Imagine 360 Contracted [320494] | $103 - $238 | 135% |
| Reflect Health Contracted [320492] | $103 - $238 | 135% |
| Yuzu Health Contracted [320521] | $103 - $238 | 135% |
| Health Choice Contracted [320166] | $108 | 142% |
| Show-Me Health Administrators Contracted [320483] | $109 - $250 | 143% |
| Preferred Health Plan Contracted [320522] | $118 - $271 | 155% |
| First Health Contracted [320128] | $123 - $284 | 162% |
| American Healthcare Alliance Contracted [320020] | $127 - $292 | 167% |
| Providrs Care Network Contracted [320484] | $136 | 179% |
| Multiplan Contracted [320270] | $139 - $321 | 183% |
| Private Health Care Systems Contracted [320320] | $139 - $321 | 183% |
| Usable Contracted [320409] | $139 - $321 | 183% |
| Point C [20238] | $145 - $334 | 190% |
| Workers Comp [20426] | $145 - $417 | 190% |
| Usa Managed Care Org Contracted [320429] | $159 - $367 | 209% |
| Ppo Plus Contracted [320310] | $163 - $375 | 214% |
| 90 Degree Benefits Contracted [320436] | $195 | 256% |