CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: Licking Memorial Hospital

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 92507
  • Insurance Median: $391
  • Cash Discount Price: $478
  • vs. Medicare Baseline: 5.13x Medicare
The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at Licking Memorial Hospital is $391. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $478. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 5.13x the Medicare baseline. Located in 1320 West Main Street, Newark, OH.
Cash / Self-Pay
$478

Average discount available for prompt cash payment at this facility.

Insurance Median
$391

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: $478 (628%)
Insurance Median: $391 (513%)
Cash: $478 (628% of Medicare)
Ins. Median: $391 (513% 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 513% of the Medicare baseline (a markup of 413%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Tricare $70 92%
Aetna $72 - $395 95%
Blue Cross Blue Shield $72 - $411 95%
Champva [500001] $72 95%
Cigna $72 - $430 95%
Humana $72 - $464 95%
Medicare (plans) $72 95%
UnitedHealthcare $72 - $407 95%
Veterans Administration [100068] $72 95%
Wellcare By Allwell [450104] $72 95%
Molina Marketplace [100106] $114 150%
Medical Mutual [100114] $263 - $397 345%
Medben [700068] $335 - $469 440%
Benicomp [70090] $359 471%
Consociate Health 6 Degrees [100059] $383 503%
Consociate Health [100029] $383 503%
Allied Benefit Systems [100015] $391 513%
Geha [100039] $391 513%
Gravie Administrative Services [100165] $391 513%
Meritain [100063] $391 513%
Optima [700069] $391 513%
Trustmark Small Business Benefits [100263] $391 513%
Webtpa [100127] $391 513%
Healthscope [100157] $407 534%
Surest [100016] $407 534%
United Medical Resources [700071] $407 534%
American Postal Workers [100089] $430 565%
Antidote Health Plan Of Ohio [70006803] $430 565%
Coresource [100002] $430 - $478 565%
Great West Life [700064] $430 565%
National Association Of Letter Carriers [100067] $430 565%
Ohio Healthy Luminare Health [100264] $430 565%
Ohio Healthy [100255] $430 565%
Ohio Ppo Connect [70006801] $430 565%
Osu Prime Care [100254] $430 565%
Quality Care Partners [70006802] $430 565%
The Health Plan [100261] $430 565%
Wellfleet Group, Llc [100164] $430 565%
Coventry [100010] $441 579%
Pan American Life [700070] $441 579%
Ohio Health Choice [100109] $459 603%
Administrative Concepts [100006] $464 609%
Carefactor [100087] $464 609%
Philadelphia American Life [100260] $464 - $478 609%
Reliance Standard-Asrm [100258] $464 609%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1320 West Main Street, Newark, OH 43055
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals