CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: Raritan Bay Medical Center

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 92507
  • Insurance Median: $283
  • Cash Discount Price: $98
  • vs. Medicare Baseline: 3.72x Medicare
The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at Raritan Bay Medical Center is $283. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $98. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 3.72x the Medicare baseline. Located in 530 New Brunswick Ave, Perth Amboy, NJ.
Cash / Self-Pay
$98

Average discount available for prompt cash payment at this facility.

Insurance Median
$283

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: $98 (129%)
Insurance Median: $283 (372%)
Cash: $98 (129% of Medicare)
Ins. Median: $283 (372% 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 372% of the Medicare baseline (a markup of 272%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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 $55 - $323 72%
Horizon $60 - $399 79%
Clover $74 97%
Seoul Medical Group $85 112%
Activecare First McO $90 118%
Amerigroup $98 - $105 129%
Vaccn $98 129%
United Community/Americhoice $103 135%
UnitedHealthcare $118 - $374 155%
Karna $132 173%
Qualcare $156 - $166 205%
Wellcare $224 294%
Oxford $265 348%
Bergen Risk $310 407%
Cigna $330 - $395 433%
Multiplan - PHCS $351 461%
Amerihealth $357 - $402 469%
Brighton Health Plan $372 489%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 530 New Brunswick Ave, Perth Amboy, NJ 08861
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals