CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: St John's Riverside Hospital

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 92507
Insurance Median: $85
Cash Discount Price: $320
vs. Medicare Baseline: 1.12x Medicare

The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at St John's Riverside Hospital is $85. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $320. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 1.12x the Medicare baseline. Located in 976 North Broadway, Yonkers, NY.

Cash / Self-Pay

$320

Average discount available for prompt cash payment at this facility.

Insurance Median

$85

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: $320 (420%)

Insurance Median: $85 (112%)

Cash: $320 (420% of Medicare)

Ins. Median: $85 (112% 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.

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
Fidelis Essential Plans	$73	96%
Medicaid / KanCare	$73	96%
Fidelis Health Benefit Exchange	$81	106%
Aetna	$85 - $3,783	112%
Centers Plan For Healthy Living	$85	112%
Fidelis	$85	112%
Healthfirst	$85	112%
Hip Health Plan	$85	112%
Magnacare	$85	112%
Medicare (plans)	$85	112%
Mvp	$85	112%
Mvp Bhs	$85	112%
Oscar	$85 - $90	112%
Partners Health Plan	$85	112%
United Behavioral Health Of Ny Ipa	$85	112%
Village Caremax	$85	112%
Wellcare	$85	112%
Metroplus Gold	$90	118%
Mvp Individual Exchange.Student Health Plan	$148	194%
UnitedHealthcare	$169 - $171	222%
Emblem Health	$174 - $229	228%
Mvp Commercial	$175	230%
Cigna	$207	272%
Empire Hmo	$254	334%

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 $320.
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 St John's Riverside Hospital 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.