CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: Blue Ridge Regional Hospital

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 92507
Insurance Median: $117
Cash Discount Price: $290
vs. Medicare Baseline: 1.54x Medicare

The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at Blue Ridge Regional Hospital is $117. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $290. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 1.54x the Medicare baseline. Located in 125 Hospital Drive, Spruce Pine, NC.

Cash / Self-Pay

$290

Average discount available for prompt cash payment at this facility.

Insurance Median

$117

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: $290 (381%)

Insurance Median: $117 (154%)

Cash: $290 (381% of Medicare)

Ins. Median: $117 (154% 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
Blue Cross Blue Shield	$44 - $51	58%
United	$47 - $144	62%
Amerihealth	$48 - $53	63%
Wellcare	$48 - $53	63%
Partners Health Management	$49 - $54	64%
Vaya Health	$49 - $54	64%
Aetna	$55 - $220	72%
Apex Health	$55 - $61	72%
Cigna	$94 - $125	123%
Amerihealth Caritas	$102 - $113	134%
Caresource	$121 - $134	159%
Medcost	$129 - $158	169%
Magellan	$166 - $183	218%
Magellan Behavioral Health	$166 - $183	218%
Multiplan	$221 - $244	290%
Avalon Administrative Services	$235 - $259	309%
Prime Health	$243 - $274	319%

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 $290.
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 Blue Ridge Regional Hospital 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.