CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: Phelps Memorial Health Center

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 92507
Insurance Median: $274
Cash Discount Price: $309
vs. Medicare Baseline: 3.60x Medicare

The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at Phelps Memorial Health Center is $274. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $309. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 3.60x the Medicare baseline. Located in 1215 Tibbals St, Holdrege, NE.

Cash / Self-Pay

$309

Average discount available for prompt cash payment at this facility.

Insurance Median

$274

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: $309 (406%)

Insurance Median: $274 (360%)

Cash: $309 (406% of Medicare)

Ins. Median: $274 (360% 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 360% of the Medicare baseline (a markup of 260%). 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
UnitedHealthcare	$135 - $346	177%
Aetna	$141 - $329	185%
Blue Cross Blue Shield	$141 - $339	185%
Good Samaritan Mcr Adv - All Plans	$141 - $154	185%
Medica Mcr Adv	$141 - $154	185%
Va Ccn - All Plans	$141 - $154	185%
Wellcare Mcr Adv - All Plans	$141 - $154	185%
Molina Mcaid - All Plans	$145 - $157	190%
Three Rivers - All Plans	$170 - $184	223%
6 Degrees Hlth - All Plans	$263 - $286	345%
Partners Hlth Alliance - All Plans	$263 - $286	345%
Cpi Benefit Group-All Plans	$296 - $321	389%
Providrs Care/Wppa - All Plans	$296 - $321	389%
Provider Network Of American - All Plans	$306 - $332	402%
Medica-All Other Plans	$309 - $336	406%
Chi Health Partners - All Plans	$313 - $339	411%
First Health - All Plans	$313 - $340	411%
Midwest Ntwrk Alliance - All Plans	$313 - $339	411%
Ambetter / Centene	$368 - $399	483%

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 $309.
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 Phelps Memorial Health 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.