CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: Atrium Health Pineville

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 92507
Insurance Median: $143
Cash Discount Price: $177
vs. Medicare Baseline: 1.88x Medicare

The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at Atrium Health Pineville is $143. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $177. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 1.88x the Medicare baseline. Located in 10628 Park Rd, Charlotte, NC.

Cash / Self-Pay

$177

Average discount available for prompt cash payment at this facility.

Insurance Median

$143

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: $177 (232%)

Insurance Median: $143 (188%)

Cash: $177 (232% of Medicare)

Ins. Median: $143 (188% 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	$24 - $37	32%
Amerihealth Caritas	$24 - $36	32%
Carolina Complete Health	$24 - $37	32%
Healthy Blue	$24 - $37	32%
Partners	$24 - $35	32%
Trillium	$24 - $38	32%
UnitedHealthcare	$24 - $195	32%
Vaya	$24 - $37	32%
Wellcare	$24 - $37	32%
Blue Cross Blue Shield	$33 - $137	43%
Cigna	$72 - $238	95%
Humana	$74	97%
Aetna	$75 - $293	98%
Ortho Carolina	$90	118%
Ambetter / Centene	$103 - $128	135%
Employers Health Network	$156	205%
Physician Reach Out	$177	232%
Medcost	$190 - $211	250%
Magellan	$212	278%
Gmmi	$229	301%
Quik Trip	$229	301%
Choicecare	$254 - $261	334%
Healthgram	$282	370%
Provider Select	$286 - $318	376%
Private Health Care Systems	$290	381%
First Health	$293	385%
Beechstreet	$318	418%
Multiplan	$325	427%

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 $177.
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 Atrium Health Pineville 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.