CMS Price Transparency Data
Speech therapy (language evaluation)
Facility: Mercy St Francis Hospital
Billing Code: 92507 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 92507
- Insurance Median: $191
- Cash Discount Price: $183
- vs. Medicare Baseline: 2.51x Medicare
The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at Mercy St Francis Hospital is $191. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $183. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 2.51x the Medicare baseline. Located in 100 West Highway 60, Po Box 82, Mountain View, MO.
Cash / Self-Pay
$183
Average discount available for prompt cash payment at this facility.
Insurance Median
$191
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: $183 (240%)
Insurance Median: $191 (251%)
Cash: $183 (240% of Medicare)
Ins. Median: $191 (251% 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 251% of the Medicare baseline (a markup of 151%). 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 |
|---|---|---|
| Tricare | $50 - $141 | 66% |
| Aetna | $51 - $368 | 67% |
| Blue Cross Blue Shield | $51 - $402 | 67% |
| Cherokee Nation Health Serv Contracted [320066] | $51 - $142 | 67% |
| Cigna | $51 - $393 | 67% |
| Cross Timbers Hospice [20098] | $51 - $142 | 67% |
| Dept Of Veteran Affairs Contracted [320106] | $51 - $142 | 67% |
| Elara Caring Aspire Hospice [20433] | $51 - $142 | 67% |
| Globalhealth Contracted [320145] | $51 - $142 | 67% |
| Halo Hcr Inc Hospice Contracted [320432] | $51 - $142 | 67% |
| Halo Hcr Inc Hospice [20432] | $51 - $142 | 67% |
| Humana | $51 - $373 | 67% |
| Indian Health Service Contracted [320198] | $51 - $142 | 67% |
| Kindful Hospice Contracted [320434] | $51 - $142 | 67% |
| Kindful Hospice [20434] | $51 - $142 | 67% |
| Medical Associates Health Contracted [320444] | $51 - $142 | 67% |
| Medicare (plans) | $51 - $148 | 67% |
| Mercy Hospice Okc [20252] | $51 - $142 | 67% |
| Mercy Mgd Behavioral Health Contracted [320259] | $51 - $142 | 67% |
| Pace Of The Ozarks Contracted [320518] | $51 - $142 | 67% |
| Provider Partners Health Plans Contracted [320450] | $51 - $142 | 67% |
| Qual Choice Contracted [320325] | $51 - $142 | 67% |
| UnitedHealthcare | $51 - $393 | 67% |
| Administrative Payor Contracted [320005] | $67 - $186 | 88% |
| Healthscope Contracted [320182] | $67 - $189 | 88% |
| Ambetter / Centene | $77 - $215 | 101% |
| Home State Health Plan Contracted [320187] | $77 - $215 | 101% |
| Medicaid / KanCare | $77 - $215 | 101% |
| Novasys Contracted [320285] | $77 - $215 | 101% |
| Centivo Contracted [320505] | $86 - $240 | 113% |
| Healthlink Contracted [320179] | $96 - $393 | 126% |
| Preferred Health Plan Contracted [320522] | $96 - $269 | 126% |
| Workers Comp [20426] | $118 - $352 | 155% |
| Auxiant Contracted [320462] | $133 - $393 | 175% |
| Mercy Benefit Admin Contracted [320251] | $133 - $393 | 175% |
| Point C Contracted [320238] | $133 - $393 | 175% |
| United Medical Resources Contracted [320454] | $133 - $385 | 175% |
| Medica Contracted [320239] | $140 - $391 | 184% |
| 90 Degree Benefits Contracted [320436] | $141 - $393 | 185% |
| Aither Health Contracted [320449] | $141 - $393 | 185% |
| Benefit Management Contracted [320052] | $141 - $393 | 185% |
| Ebms Contracted [320493] | $141 - $393 | 185% |
| Edison Health Solutions Contracted [320502] | $141 - $393 | 185% |
| Evolutions Health Care Contracted [320124] | $141 - $393 | 185% |
| First Health Contracted [320128] | $141 - $393 | 185% |
| Health Systems Inc Contracted [320174] | $141 - $393 | 185% |
| Imagine 360 Contracted [320494] | $141 - $393 | 185% |
| Insurance System Inc Contracted [320465] | $141 - $393 | 185% |
| Multiplan Contracted [320270] | $141 - $393 | 185% |
| Point C [20238] | $141 - $393 | 185% |
| Private Health Care Systems Contracted [320320] | $141 - $393 | 185% |
| Reflect Health Contracted [320492] | $141 - $393 | 185% |
| Show-Me Health Administrators Contracted [320483] | $141 - $393 | 185% |
| Usa Managed Care Org Contracted [320429] | $141 - $393 | 185% |
| Yuzu Health Contracted [320521] | $141 - $393 | 185% |