CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: Caromont Regional Medical Center

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 92507
Insurance Median: $78
Cash Discount Price: $224
vs. Medicare Baseline: 1.02x Medicare

The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at Caromont Regional Medical Center is $78. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $224. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 1.02x the Medicare baseline. Located in 2525 Court Dr, Gastonia, NC.

Cash / Self-Pay

$224

Average discount available for prompt cash payment at this facility.

Insurance Median

$78

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: $224 (294%)

Insurance Median: $78 (102%)

Cash: $224 (294% of Medicare)

Ins. Median: $78 (102% 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
Alliance Behavioral Health	$34	45%
Amerihealth Caritas	$34	45%
Blue Cross Blue Shield	$34 - $74	45%
Carolina Complete Health	$34	45%
Carolina Complete Health Tailored Plans	$34	45%
Partners Behavioral Health	$34	45%
UnitedHealthcare	$34 - $148	45%
Vaya Behavioral Health	$34	45%
Wellcare	$34	45%
Absolute Total Care	$63	83%
Molina	$63 - $78	83%
Gaston County Jail	$67	88%
Aetna	$77 - $111	101%
Devoted Health	$78	102%
Healthteam	$78	102%
Longevity Health	$78	102%
Humana	$79 - $197	104%
Surgery Plus	$129	169%
Cigna	$134 - $137	176%
Medcost	$152	200%
Carolina Caring	$177 - $185	232%
Beech Street	$184	242%
Multiplan	$184	242%
Corporate Benefits Service	$199	261%
Self Pay	$202	265%
First Health Network	$213	280%

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 $224.
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 Caromont Regional 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.