CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: St John's Episcopal Hospital at South Shore

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 92507
Insurance Median: $85
Cash Discount Price: $309
vs. Medicare Baseline: 1.12x Medicare

The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at St John's Episcopal Hospital at South Shore is $85. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $309. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 1.12x the Medicare baseline. Located in 327 Beach 19Th Street, Far Rockaway, NY.

Cash / Self-Pay

$309

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: $309 (406%)

Insurance Median: $85 (112%)

Cash: $309 (406% 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
Healthfirst	$71 - $191	93%
Vns	$81 - $85	106%
Aetna	$85 - $119	112%
Blue Cross Blue Shield	$85 - $128	112%
Centerlight	$85	112%
Centers Plan For Healthy Living	$85	112%
Elderplan	$85	112%
Emblem Health	$85	112%
Fidelis	$85	112%
Hamaspik	$85	112%
Humana	$85	112%
Longevity	$85	112%
Lucida	$85	112%
Metroplus	$85	112%
UnitedHealthcare	$85	112%
Village Care Max	$85	112%
Wellcare	$85	112%
Molina	$93	122%
Magnacare	$174	228%

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 $309.
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 Episcopal Hospital at South Shore 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.