CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: Lodi Community Hospital

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 92507
Insurance Median: $237
Cash Discount Price: $285
vs. Medicare Baseline: 3.11x Medicare

The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at Lodi Community Hospital is $237. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $285. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 3.11x the Medicare baseline. Located in 225 Elyria Street, Lodi, OH.

Cash / Self-Pay

$285

Average discount available for prompt cash payment at this facility.

Insurance Median

$237

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: $285 (374%)

Insurance Median: $237 (311%)

Cash: $285 (374% of Medicare)

Ins. Median: $237 (311% 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 311% of the Medicare baseline (a markup of 211%). 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
UnitedHealthcare	$83 - $272	109%
Buckeye	$87	114%
Caresource	$87	114%
Blue Cross Blue Shield	$91 - $358	120%
Molina	$91	120%
United	$91 - $313	120%
Amerihealth	$96	126%
Humana	$131	172%
Mmo	$131 - $234	172%
Summacare	$131 - $268	172%
Oscar	$132 - $168	173%
Aetna	$149 - $438	196%
The Health Plan	$175 - $350	230%
Amish Community Aid Plan	$197 - $219	259%
Ohcp	$213	280%
Aultcare	$219	288%
Omas	$219	288%
Ohio Healthy	$237	311%
Php	$263	345%
Phphi	$263	345%
Upmc	$263	345%
Cigna	$283	372%
Cc Ehp	$294	386%
Gms	$307	403%
Medical Benefit Corp	$307	403%
Consociate Health	$328	431%
Frontpath	$394	517%
Managed Care Services	$394	517%
Multiplan	$394	517%
Tertiary Care Network	$394	517%

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 $285.
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 Lodi Community 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.