CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: Howard County Medical Center

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 92507
Insurance Median: $170
Cash Discount Price: $318
vs. Medicare Baseline: 2.23x Medicare

The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at Howard County Medical Center is $170. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $318. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 2.23x the Medicare baseline. Located in P O Box 406, 1113 Sherman St, St Paul, NE.

Cash / Self-Pay

$318

Average discount available for prompt cash payment at this facility.

Insurance Median

$170

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: $318 (418%)

Insurance Median: $170 (223%)

Cash: $318 (418% of Medicare)

Ins. Median: $170 (223% 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 223% of the Medicare baseline (a markup of 123%). 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
Molina Healthcare	$17 - $159	22%
Nebraska Total Care	$17 - $159	22%
UnitedHealthcare	$17 - $305	22%
Aetna	$37 - $302	49%
Humana	$61	80%
Blue Cross Blue Shield	$72 - $341	95%
Great Plains	$72 - $181	95%
Medica Chi	$72 - $181	95%
Medica Standard Premier	$72	95%
Tricare	$72 - $238	95%
Medica Elevate	$73 - $141	96%
Nebraska Total Care - Wellcare	$74	97%
Ambetter / Centene	$108	142%
Oscar Health	$125	164%
Beshp	$143	188%
Midland'S Choice	$148	194%
Medica Chi Aco	$289	380%
Medica Choice National	$289	380%
Medica Ifb Aco	$305	401%
Medica Ifb Open Access	$305	401%

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 $318.
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 Howard County 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.