CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: Adena Regional Medical Center

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 92507
Insurance Median: $283
Cash Discount Price: $208
vs. Medicare Baseline: 3.72x Medicare

The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at Adena Regional Medical Center is $283. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $208. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 3.72x the Medicare baseline. Located in 272 Hospital Road, Chillicothe, OH.

Cash / Self-Pay

$208

Average discount available for prompt cash payment at this facility.

Insurance Median

$283

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: $208 (273%)

Insurance Median: $283 (372%)

Cash: $208 (273% of Medicare)

Ins. Median: $283 (372% 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 372% of the Medicare baseline (a markup of 272%). 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	$72 - $297	95%
Buckeye Community Health Plan	$72	95%
Humana	$72 - $396	95%
Medical Mutual Of Ohio	$72 - $275	95%
Medigold	$72	95%
Molina	$72	95%
UnitedHealthcare	$72 - $301	95%
Care Source	$74	97%
Gateway Health	$74	97%
Molina Marketplace	$119	156%
Care Source Just4Me	$130	171%
Cigna	$149 - $258	196%
Blue Cross Blue Shield	$189 - $265	248%
Sidecar Health	$199	261%
Ohio Ppo Connect	$292	383%
The Health Plan	$292	383%
First Health	$327	429%
Ohio Health Choice	$332	436%
Healthsmart	$354	465%
Integrated Health Plan	$396	520%
Multiplan/Private Healthcare Systems	$396	520%
Three Rivers Network	$396	520%

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 $208.
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 Adena Regional 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.