CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: Carolina East Medical Center

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 92507
Insurance Median: $216
Cash Discount Price: $178
vs. Medicare Baseline: 2.84x Medicare

The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at Carolina East Medical Center is $216. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $178. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 2.84x the Medicare baseline. Located in 2000 Neuse Blvd, New Bern, NC.

Cash / Self-Pay

$178

Average discount available for prompt cash payment at this facility.

Insurance Median

$216

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: $178 (234%)

Insurance Median: $216 (284%)

Cash: $178 (234% of Medicare)

Ins. Median: $216 (284% 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 284% of the Medicare baseline (a markup of 184%). 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
Humana	$74	97%
Inclusive Health (Nchirp)-All Plans	$74	97%
Pamlico Co Jail-All Plans	$79	104%
Craven Co. Jail Systems - All Plans	$100	131%
Medcost Ppo Ultra (Employees)	$185	243%
Medcost Ppo Employees And Retirees	$194	255%
Blue Cross Blue Shield	$203	267%
UnitedHealthcare	$210	276%
Medcost Ppo City Employees	$216	284%
Medcost Ppo County Employee	$224	294%
Benefit Mgmt, Svcs-All Plans	$252	331%
Aetna	$262	344%
Medcost Benefit Svc-All Other Plans	$262	344%
Acs Consult Svc Inc-All Plans	$267	351%
Medcost Ppo Standard	$267	351%
Cigna	$269	353%
Tricare	$296	389%

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 $178.
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 Carolina East 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.