CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: Nationwide Children's Hospital

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 92507
Insurance Median: $217
Cash Discount Price: $243
vs. Medicare Baseline: 2.85x Medicare

The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at Nationwide Children's Hospital is $217. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $243. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 2.85x the Medicare baseline. Located in 700 Children's Drive, Columbus, OH.

Cash / Self-Pay

$243

Average discount available for prompt cash payment at this facility.

Insurance Median

$217

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: $243 (319%)

Insurance Median: $217 (285%)

Cash: $243 (319% of Medicare)

Ins. Median: $217 (285% 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 285% of the Medicare baseline (a markup of 185%). 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
Tricare	$69	91%
Aetna	$76 - $256	100%
Blue Cross Blue Shield	$83 - $254	109%
Amerihealth	$109	143%
Bchp	$109	143%
Caresource	$109 - $150	143%
Humana	$109 - $256	143%
Molina	$109	143%
UnitedHealthcare	$109 - $256	143%
Mmo	$194 - $254	255%
Cigna	$202 - $254	265%
Front Path Health Coalition	$202 - $254	265%
Ohc	$202 - $251	265%
Ohg	$202 - $243	265%
Ohio Ppo Connect	$202 - $251	265%
Osu	$202 - $251	265%
The Health Plan	$202 - $259	265%
Ahpo	$254	334%
Unicare	$256	336%
Emerald Health	$265	348%
First Health	$265	348%
Phcs	$265	348%

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 $243.
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 Nationwide Children's 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.