CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: Bayshore Medical Center

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 92507
Insurance Median: $300
Cash Discount Price: $98
vs. Medicare Baseline: 3.94x Medicare

The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at Bayshore Medical Center is $300. 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 3.94x the Medicare baseline. Located in 727 N Beers St, Holmdel, NJ.

Cash / Self-Pay

$98

Average discount available for prompt cash payment at this facility.

Insurance Median

$300

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: $300 (394%)

Cash: $98 (129% of Medicare)

Ins. Median: $300 (394% 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 394% of the Medicare baseline (a markup of 294%). 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
Horizon	$60 - $356	79%
Clover	$74	97%
Seoul Medical Group	$77	101%
Aetna	$98 - $323	129%
Amerigroup	$98	129%
Vaccn	$98	129%
United Community/Americhoice	$103	135%
UnitedHealthcare	$118 - $357	155%
Wellcare	$224	294%
Qualcare	$278 - $321	365%
Bergen Risk	$310	407%
Cigna	$330 - $395	433%
Multiplan - PHCS	$351	461%
Amerihealth	$355 - $402	466%
Brighton Health Plan	$372	489%
Oxford	$614	806%

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 $98.
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 Bayshore 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.