CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: St Mary's Healthcare

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 92507
  • Insurance Median: $108
  • Cash Discount Price: $154
  • vs. Medicare Baseline: 1.42x Medicare
The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at St Mary's Healthcare is $108. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $154. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 1.42x the Medicare baseline. Located in 427 Guy Park Avenue, Amsterdam, NY.
Cash / Self-Pay
$154

Average discount available for prompt cash payment at this facility.

Insurance Median
$108

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: $154 (202%)
Insurance Median: $108 (142%)
Cash: $154 (202% of Medicare)
Ins. Median: $108 (142% 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
Medicare (plans) $74 - $83 97%
Tricare $74 97%
Va $74 97%
Blue Cross Blue Shield $77 - $174 101%
Aetna $78 - $214 102%
Humana $78 102%
Carelon_Commercial $98 - $124 129%
Carelon_Empire $98 - $124 129%
Medicaid / KanCare $107 - $120 141%
UnitedHealthcare $107 141%
Cdphp_Commercial $138 - $174 181%
Excellus_Commercial $146 - $184 192%
Emblem_Commercial $148 - $187 194%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 427 Guy Park Avenue, Amsterdam, NY 12010
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals