Speech therapy (language evaluation)
Facility: Golden Valley Memorial Hospital
Billing Code: 92507 (CPT)
- CPT Billing Code: 92507
- Insurance Median: $73
- Cash Discount Price: $167
- vs. Medicare Baseline: 0.96x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Aetna | $70 | 92% |
| Humana | $70 | 92% |
| UnitedHealthcare | $70 - $120 | 92% |
| Home State Health | $73 | 96% |
| Ambetter / Centene | $85 | 112% |
| Medica | $166 | 218% |
Consumer Guidance & Cost Commentary
For speech therapy (language evaluation) at Golden Valley Memorial Hospital in Clinton, MO, the cash median rate is $167, which is significantly lower than the facility's gross charge of $278. While this cash price is notably higher than the state average of $73 for the same service, patients with high-deductible plans may find the direct cash payment more economical than relying on insurance, as the negotiated rates for some payers can exceed the cash price. For instance, UnitedHealthcare negotiates a rate of $120, while Medica's rate is $166, both of which are higher than the available cash option.
The facility, owned by a Government Hospital District or Authority, holds a rating of 3 stars and serves 6 payers for this procedure. Although the facility's cash rate is above the state average, it remains below the gross charges, and patients should explicitly ask about "self-pay" or "prompt-pay" discounts before scheduling to potentially lower the final amount. Given that over 80% of hospital bills often contain errors, consumers are advised to request a full itemized CPT-coded statement rather than accepting a summary bill, and to verify their deductible status before using insurance to ensure they are not paying out-of-pocket amounts that could have been covered.