CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: Wayne General Hospital

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 92507
Insurance Median: $145
Cash Discount Price: $168
vs. Medicare Baseline: 1.90x Medicare

The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at Wayne General Hospital is $145. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $168. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 1.90x the Medicare baseline. Located in 950 Matthew Dr, Waynesboro, MS.

Cash / Self-Pay

$168

Average discount available for prompt cash payment at this facility.

Insurance Median

$145

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: $168 (221%)

Insurance Median: $145 (190%)

Cash: $168 (221% of Medicare)

Ins. Median: $145 (190% 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.

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
Humana	$64	84%
Ml Healthcare-All Plans	$66 - $68	87%
Al Healthcare Adv Mcaid-All Plans	$67	88%
Alabama Community Mcaid-All Plans	$67	88%
Medicaid / KanCare	$67	88%
Univita Healthcare Mcaid-All Plans	$67	88%
Amerigroup Mcare Adv-All Plans	$72	95%
Cigna	$72 - $100	95%
Magnolia Mcare Adv	$72	95%
Molina Mcare Adv	$72	95%
Vantage Health Mcare Adv	$72	95%
Wellcare Mcare Adv-All Plans	$72	95%
Molina Chip-All Other Plans	$74	97%
Ahs-All Plans	$116 - $119	152%
Phcs-All Plans	$124 - $128	163%
Mhci/Healthlink Op Only-All Plans	$140 - $144	184%
Ms Health Partners-All Plans	$140 - $144	184%
Ppoplus-All Plans	$140 - $144	184%
First Choice-All Other Plans	$148 - $153	194%
First Health-All Plans	$148 - $153	194%
Geha Ppo-All Plans	$148 - $153	194%
Healthcare Advantage-All Plans	$148 - $153	194%
United Providers-All Plans	$148 - $153	194%
Three Rivers Provider Network-All Plans	$157 - $162	206%
Aetna	$165 - $170	217%
Magnolia Comm/Exchange-All Other Plans	$165 - $170	217%
Vantage Health-All Other Plans	$165	217%
First Choice Hie	$206 - $212	271%
Blue Cross Blue Shield	$309 - $318	406%

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 $168.
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 Wayne General 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.