CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: Hermann Area District Hospital

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 92507
Insurance Median: $189
Cash Discount Price: $191
vs. Medicare Baseline: 2.48x Medicare

The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at Hermann Area District Hospital is $189. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $191. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 2.48x the Medicare baseline. Located in 509 W 18Th St, Hermann, MO.

Cash / Self-Pay

$191

Average discount available for prompt cash payment at this facility.

Insurance Median

$189

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: $191 (251%)

Insurance Median: $189 (248%)

Cash: $191 (251% of Medicare)

Ins. Median: $189 (248% 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 248% of the Medicare baseline (a markup of 148%). 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
Harmony Hp Mcaid- All Plans	$50	66%
Care Partners Mcaid- All Plans	$52	68%
Healthy Blue Mcaid - All Plans	$59	77%
Ambetter / Centene	$61 - $100	80%
Blue Cross Blue Shield	$64 - $233	84%
UnitedHealthcare	$64 - $223	84%
Tricare	$104 - $210	137%
Choicecare Mcr Adv- All Plans	$111 - $223	146%
American Hlth Mcr Adv- All Plans	$116 - $233	152%
Humana	$116 - $233	152%
Aetna	$118 - $504	155%
Wellcare Mcr Adv - All Plans	$118 - $238	155%
Cigna	$157 - $315	206%
Healthcare Usa Mcaid- All Plans	$171 - $345	225%
Healthlink Hmo	$171 - $345	225%
Healthlink Ppo - All Other Plans	$198 - $398	260%
Multiplan/Phcs - All Plans	$198 - $398	260%
Coventry - All Plans	$224 - $451	294%
Comp Results - All Plans	$237 - $477	311%
Three Rivers - All Plans	$237 - $477	311%

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 $191.
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 Hermann Area District 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.