CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: Saratoga Hospital

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 92507
Insurance Median: $115
Cash Discount Price: $64
vs. Medicare Baseline: 1.51x Medicare

The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at Saratoga Hospital is $115. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $64. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 1.51x the Medicare baseline. Located in 211 Church Street, Saratoga Springs, NY.

Cash / Self-Pay

$64

Average discount available for prompt cash payment at this facility.

Insurance Median

$115

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: $64 (84%)

Insurance Median: $115 (151%)

Cash: $64 (84% of Medicare)

Ins. Median: $115 (151% 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
Aetna	$22 - $206	29%
Blue Cross Blue Shield	$72 - $290	95%
Emblem	$77 - $109	101%
Empire Plan Nyship	$90	118%
Mvp Commercial	$90 - $215	118%
Multiplan	$96 - $109	126%
Cdphp	$98 - $353	129%
Fidelis	$98 - $353	129%
UnitedHealthcare	$109 - $157	143%
Magnacare	$115 - $122	151%
Hamaspik	$134 - $369	176%
Mvp Essential Plan	$157 - $314	206%
Mvp Govt Programs	$157	206%
Blue Shield	$261	343%

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 $64.
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 Saratoga 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.