CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: Novant Health Forsyth Medical Center

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 92507
Insurance Median: $181
Cash Discount Price: $161
vs. Medicare Baseline: 2.38x Medicare

The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at Novant Health Forsyth Medical Center is $181. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $161. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 2.38x the Medicare baseline. Located in 3333 Silas Creek Parkway, Winston-Salem, NC.

Cash / Self-Pay

$161

Average discount available for prompt cash payment at this facility.

Insurance Median

$181

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: $161 (211%)

Insurance Median: $181 (238%)

Cash: $161 (211% of Medicare)

Ins. Median: $181 (238% 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 238% of the Medicare baseline (a markup of 138%). 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
Carolina Complete	$48 - $51	63%
Nc Department Of Public Safety	$48 - $51	63%
Amerihealth	$49 - $52	64%
Blue Cross Blue Shield	$49 - $199	64%
UnitedHealthcare	$49 - $186	64%
Wellcare	$49 - $52	64%
Cigna	$100 - $164	131%
Caresource North Carolina	$104 - $110	137%
Aetna	$130 - $221	171%
Atlantic Corporation Dba Atlantic Packaging	$146 - $156	192%
Plotkin Health	$155 - $166	204%
Amps	$168 - $179	221%
Humana	$202 - $215	265%
Medcost	$220 - $259	289%
Primary Physician Care	$228 - $243	299%
Beechstreet	$233 - $248	306%
Multiplan	$233 - $248	306%
Phcs	$233 - $248	306%
Employers Choice Network	$251 - $268	330%
Three Rivers Provider Network	$251 - $268	330%

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 $161.
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 Novant Health Forsyth Medical Center 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.