CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: The Children's Mercy Hospital

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 92507
Insurance Median: $294
Cash Discount Price: $216
vs. Medicare Baseline: 3.86x Medicare

The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at The Children's Mercy Hospital is $294. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $216. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 3.86x the Medicare baseline. Located in 2401 Gillham Road, Kansas City, MO.

Cash / Self-Pay

$216

Average discount available for prompt cash payment at this facility.

Insurance Median

$294

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: $216 (284%)

Insurance Median: $294 (386%)

Cash: $216 (284% of Medicare)

Ins. Median: $294 (386% 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 386% of the Medicare baseline (a markup of 286%). 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
UnitedHealthcare	$81 - $303	106%
Healthy Blue	$86 - $202	113%
Medicaid / KanCare	$90	118%
Home State Health	$177	232%
Blue Cross Blue Shield	$185 - $334	243%
Cigna	$216 - $313	284%
Medica	$263	345%
Aetna	$271 - $307	356%
Centivo	$293	385%
Nebraska Furniture Mart	$293	385%
Orscheln	$293	385%
Wellfit/Centrus	$293	385%
Wppa Providrs Care	$293	385%
Health Midwest Comprehensive Care	$294	386%
Quiktrip	$294	386%
Humana	$300	394%
Coventry Health Care Of Kansas	$334	439%
Coxhealth Network	$334	439%
Mercy Health	$338	444%
Multiplan	$343	450%
American Healthcare Alliance	$383	503%
Healthlink	$397	521%
National Preferred Provider Network	$406	533%

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 $216.
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 The Children's Mercy 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.