CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: Novant Health Presbyterian Medical Center

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 92507
Insurance Median: $162
Cash Discount Price: $131
vs. Medicare Baseline: 2.13x Medicare

The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at Novant Health Presbyterian Medical Center is $162. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $131. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 2.13x the Medicare baseline. Located in 200 Hawthorne Lane Box 33549, Charlotte, NC.

Cash / Self-Pay

$131

Average discount available for prompt cash payment at this facility.

Insurance Median

$162

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: $131 (172%)

Insurance Median: $162 (213%)

Cash: $131 (172% of Medicare)

Ins. Median: $162 (213% 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 213% of the Medicare baseline (a markup of 113%). 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	$46	60%
Nc Department Of Public Safety	$46	60%
Amerihealth	$47	62%
Blue Cross Blue Shield	$47 - $189	62%
UnitedHealthcare	$47 - $153	62%
Wellcare	$47	62%
Caresource North Carolina	$86	113%
Atlantic Corporation Dba Atlantic Packaging	$121	159%
Aetna	$131 - $210	172%
Cigna	$135	177%
Amps	$144	189%
Plotkin Health	$157	206%
Medcost	$186 - $196	244%
Humana	$189	248%
Primary Physician Care	$194	255%
Multiplan	$196	257%
Phcs	$196	257%
Employers Choice Network	$254	334%
Three Rivers Provider Network	$254	334%

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 $131.
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 Presbyterian 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.