CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: Cape Regional Medical Center Inc

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 92507
Insurance Median: $224
Cash Discount Price: $113
vs. Medicare Baseline: 2.94x Medicare

The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at Cape Regional Medical Center Inc is $224. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $113. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 2.94x the Medicare baseline. Located in Two Stone Harbor Blvd, Cape May Court House, NJ.

Cash / Self-Pay

$113

Average discount available for prompt cash payment at this facility.

Insurance Median

$224

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: $113 (148%)

Insurance Median: $224 (294%)

Cash: $113 (148% of Medicare)

Ins. Median: $224 (294% 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 294% of the Medicare baseline (a markup of 194%). 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
Aetna	$55 - $159	72%
Americhoice	$55 - $104	72%
Amerigroup	$58 - $60	76%
Horizon Nj Health	$60	79%
Clover Health	$104	137%
Cigna	$119 - $132	156%
Qualcare	$132 - $224	173%
Partners Direct Health	$162	213%
Blue Cross Blue Shield	$275 - $298	361%
Horizon Casualty Motor Vehicle	$343 - $357	450%
Horizon Casualty Workers Comp	$343 - $357	450%
Amerihealth	$353 - $367	464%
UnitedHealthcare	$380 - $452	499%

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 $113.
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 Cape Regional Medical Center Inc 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.