CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: Essentia Health

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 92507
  • Insurance Median: $148
  • Cash Discount Price: $213
  • vs. Medicare Baseline: 1.94x Medicare
The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at Essentia Health is $148. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $213. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 1.94x the Medicare baseline. Located in 3000 32Nd Ave South, Fargo, ND.
Cash / Self-Pay
$213

Average discount available for prompt cash payment at this facility.

Insurance Median
$148

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: $213 (280%)
Insurance Median: $148 (194%)
Cash: $213 (280% of Medicare)
Ins. Median: $148 (194% 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.

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
Advocare/Security Health $75 98%
Blue Cross Blue Shield $75 - $357 98%
Freedom Blue Ppo $75 98%
Healthpartners Care Msho / Mcr Adv $75 98%
Imcare Msho Pcc Prime $75 98%
Imcare Msho Ref Req $75 98%
Itasca Med Care $75 98%
Medica Advantage Solutions $75 98%
Medica Msho/Dual Solutions $75 98%
Medica Prime Solution Group $75 98%
Medicare (plans) $75 98%
Nd Va Administration $75 98%
Platinum Blue/Vantage Blue $75 98%
Primewest Msho $75 98%
Secure Blue Msho $75 98%
Ubh Cost Plan $75 98%
Ubh Msho $75 98%
Ucare Msho $75 98%
UnitedHealthcare $75 - $226 98%
Medica Access $76 100%
Primewest $76 100%
Healthpartners Care Pmap $110 144%
Sanford Health Plan $122 - $156 160%
Medica $157 - $175 206%
Medica Uplan $157 206%
Medica Choice $180 236%
Ucare $187 246%
Cigna $190 250%
Healthpartners $190 250%
Healthpartners Pcc Prime $190 250%
Wea $204 - $219 268%
America'S Ppo $220 289%
Wps $236 - $239 310%
Aetna $241 316%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3000 32Nd Ave South, Fargo, ND 58104
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals