CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: Samaritan Hospital of Troy, New York

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 92507
  • Insurance Median: $144
  • Cash Discount Price: $94
  • vs. Medicare Baseline: 1.89x Medicare
The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at Samaritan Hospital of Troy, New York is $144. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $94. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 1.89x the Medicare baseline. Located in 2215 Burdett Avenue, Troy, NY.
Cash / Self-Pay
$94

Average discount available for prompt cash payment at this facility.

Insurance Median
$144

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: $94 (123%)
Insurance Median: $144 (189%)
Cash: $94 (123% of Medicare)
Ins. Median: $144 (189% 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
Blue Cross Blue Shield $11 - $297 14%
Medicaid / KanCare $11 - $144 14%
UnitedHealthcare $22 - $383 29%
Medicare (plans) $73 - $144 96%
Eddy Seniorcare Pace $75 98%
Secure Horizons Ma Pffs $76 100%
Aetna $79 - $230 104%
Hudson Headwaters Pace $81 106%
Nascentia Health Plus $84 110%
First Health $115 151%
Capital District Physicians Health Plan $119 156%
Health Republic $122 160%
Independent Health $122 160%
Magnacare $122 160%
Health New England $130 171%
Multiplan $130 171%
Phcs $130 171%
Fidelis Care $135 177%
Carelon Behavioral Health $144 189%
Mvp $158 - $170 207%
Blue Shield - Ny Highmark Northeastern $167 - $297 219%
Wellpath $168 221%
1199 National Benefit Fund $230 302%
Allied Benefit Systems $230 302%
Asr Health Benefits $230 302%
Christian Brother Services $230 302%
Geha $230 302%
Lucent Health $230 302%
Luminare Health $230 302%
Medical Mutual $230 302%
Meritain $230 302%
Trustmark Small Business Benefits $230 302%
Allegiance $269 353%
American Postal Workers Secondary $269 353%
Cigna $269 353%
Diversified Administrators $269 353%
Health Partners $269 353%
Priority Health $269 353%
Tufts Health Plan $269 353%
Webtpa $269 353%
Bcn Domestic $292 383%
Blue Care Network $292 383%
Unicare $292 383%
Blue Shield - Ca $297 390%
Blue Shield - Id (Regence) $297 390%
Blue Shield - Ny Highmark Western $297 390%
Blue Shield - Pa (Highmark) $297 390%
Blue Shield - Wa (Regence) $297 390%
Emblem Health $316 415%
Nova $316 415%
Harvard Pilgrim Healthcare $383 503%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2215 Burdett Avenue, Troy, NY 12180
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals