CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: Jacobi Medical Center

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 92507
Insurance Median: $213
Cash Discount Price: Unavailable
vs. Medicare Baseline: 2.80x Medicare

The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at Jacobi Medical Center is $213. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 2.80x the Medicare baseline. Located in 1400 Pelham Parkway South, Bronx, NY.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$213

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%)

Insurance Median: $213 (280%)

Ins. Median: $213 (280% 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 280% of the Medicare baseline (a markup of 180%). 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	$53 - $192	70%
Healthfirst	$68 - $415	89%
Wellcare	$92	121%
Fidelis	$122 - $415	160%
Blue Cross Blue Shield	$145 - $415	190%
Metroplus	$172 - $415	226%
Amidacare	$185	243%
Carelon	$185 - $310	243%
Senior Whole Health	$185	243%
United	$185 - $330	243%
United Behavioral Health	$185 - $203	243%
Affinity	$188 - $415	247%
Carelon (Amida Care)	$188	247%
Vnsny	$188 - $406	247%
Villagecare Max	$209	274%
Emblem	$213 - $249	280%
Oxford	$236 - $265	310%
Centerlight	$239	314%
Cigna	$241	316%
Oscar	$251	330%
Elderplan	$310	407%
Magnacare	$358	470%
Multiplan	$382	502%
Local 1199	$406	533%

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 $X.
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 Jacobi 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.