CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: St Joseph's University Medical Center Inc

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 92507
  • Insurance Median: $126
  • Cash Discount Price: $467
  • vs. Medicare Baseline: 1.65x Medicare
The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at St Joseph's University Medical Center Inc is $126. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $467. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 1.65x the Medicare baseline. Located in 703 Main St, Paterson, NJ.
Cash / Self-Pay
$467

Average discount available for prompt cash payment at this facility.

Insurance Median
$126

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: $467 (613%)
Insurance Median: $126 (165%)
Cash: $467 (613% of Medicare)
Ins. Median: $126 (165% 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
Aetna $38 - $172 50%
Consumer Health Network $47 - $463 62%
Fidelis Care of New Jersey $63 - $103 83%
UnitedHealthcare $63 - $343 83%
Horizon New Jersey Health $65 85%
Ambetter / Centene $84 - $126 110%
Amerihealth $84 - $327 110%
Blue Cross Blue Shield $84 - $448 110%
Clover Health $84 110%
Horizon New Jersey Total Care $84 110%
Wellpoint $84 - $101 110%
Longevity Health Plan $97 127%
Multiplan $126 - $386 165%
Private Healthcare Systems $304 - $334 399%
Oxford $316 415%
Magnacare $327 - $360 429%
Oscar $440 - $484 578%
Cigna $467 - $514 613%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 703 Main St, Paterson, NJ 07503
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals