CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: Cincinnati Children's Hospital Medical Center

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 92507
  • Insurance Median: $360
  • Cash Discount Price: $233
  • vs. Medicare Baseline: 4.73x Medicare
The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at Cincinnati Children's Hospital Medical Center is $360. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $233. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 4.73x the Medicare baseline. Located in 3333 Burnet Avenue, Cincinnati, OH.
Cash / Self-Pay
$233

Average discount available for prompt cash payment at this facility.

Insurance Median
$360

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: $233 (306%)
Insurance Median: $360 (473%)
Cash: $233 (306% of Medicare)
Ins. Median: $360 (473% 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 473% of the Medicare baseline (a markup of 373%). 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
Aetna $20 - $699 26%
Humana $20 - $184 26%
Passport_Ky $21 - $191 28%
United_Health_Care_Ky $22 - $194 29%
Wellcare_Ky $22 - $194 29%
Caresource_Oh_Insurance $39 - $353 51%
Cigna $39 - $699 51%
Medical_Mutual_Of_Ohio_Insurance $51 - $699 67%
Point_Comfort_Insurance $53 - $478 70%
Blue Cross Blue Shield $62 - $723 81%
Mhs_In $62 81%
Margaret_Mary_Health_Insurance $64 - $574 84%
Parkview_Signature_Care_Insurance $64 - $574 84%
Caresource_In $65 85%
United_Health_Care_Insurance $73 - $659 96%
Health_Ohio_Network_Insurance $75 - $699 98%
Custom_Design_Benefits_Insurance $78 - $699 102%
Health_Smart_Preferred_Insurance $78 - $699 102%
Medical_Benefit_Administrators_Insurance $78 - $699 102%
Ohio_Health_Choice_Insurance $78 - $699 102%
Private_Health_Care_Systems_Insurance $79 - $707 104%
Beechstreet_Insurance $80 - $721 105%
First_Health_Group_Insurance $80 - $721 105%
Health_Link_Insurance $80 - $721 105%
Amerihealth_Caritas_Oh $82 - $114 108%
Buckeye_Oh $82 - $121 108%
Caresource_Oh $82 - $106 108%
Evolutions_Health_Care_Systems $82 - $736 108%
Galaxy_Health_Insurance $82 - $736 108%
Molina_Oh $82 - $116 108%
United_Health_Care_Oh $82 - $111 108%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3333 Burnet Avenue, Cincinnati, OH 45229
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens