CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: Mercy Hospital Ada

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 92507
Insurance Median: $366
Cash Discount Price: $393
vs. Medicare Baseline: 4.81x Medicare

The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at Mercy Hospital Ada is $366. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $393. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 4.81x the Medicare baseline. Located in 430 North Monte Vista, Ada, OK.

Cash / Self-Pay

$393

Average discount available for prompt cash payment at this facility.

Insurance Median

$366

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: $393 (516%)

Insurance Median: $366 (481%)

Cash: $393 (516% of Medicare)

Ins. Median: $366 (481% 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 481% of the Medicare baseline (a markup of 381%). 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	$68 - $754	89%
Humana	$68 - $71	89%
Medicaid / KanCare	$68 - $96	89%
Blue Cross Blue Shield	$70	92%
Cherokee Nation Health Serv Contracted [320066]	$70	92%
Cross Timbers Hospice [20098]	$70	92%
Dept Of Veteran Affairs Contracted [320106]	$70	92%
Elara Caring Aspire Hospice Contracted [320433]	$70	92%
Elara Caring Aspire Hospice [20433]	$70	92%
Halo Hcr Inc Hospice Contracted [320432]	$70	92%
Halo Hcr Inc Hospice [20432]	$70	92%
Independent Health [20197]	$70	92%
Indian Health Service Contracted [320198]	$70	92%
Kindful Hospice Contracted [320434]	$70	92%
Kindful Hospice [20434]	$70	92%
Medical Associates Health [20444]	$70	92%
Medicare (plans)	$70 - $1,003	92%
Mercy Hospice Okc [20252]	$70	92%
Provider Partners Health Plans Contracted [320450]	$70	92%
Qual Choice Contracted [320325]	$70	92%
Tricare	$70	92%
UnitedHealthcare	$70 - $702	92%
Globalhealth Contracted [320145]	$71	93%
Cigna	$72	95%
Healthcare Highways Plus Contracted [320175]	$80 - $752	105%
Webtpa Contracted [320417]	$86 - $421	113%
Osma Health Contracted [320292]	$92 - $451	121%
Medica Contracted [320239]	$95 - $1,003	125%
Ambetter / Centene	$96	126%
Home State Health Plan Contracted [320187]	$96	126%
Novasys Contracted [320285]	$96	126%
Benefit Management Contracted [320052]	$102 - $652	134%
Health Choice Contracted [320166]	$119	156%
Aither Health Contracted [320449]	$123 - $602	162%
Auxiant Contracted [320462]	$123 - $602	162%
Ebms Contracted [320493]	$123 - $602	162%
Federal Medical Center Contracted [320127]	$123 - $602	162%
Healthlink Contracted [320179]	$123 - $602	162%
Healthscope Contracted [320182]	$123 - $602	162%
Imagine 360 Contracted [320494]	$123 - $602	162%
Mercy Benefit Admin Contracted [320251]	$123 - $652	162%
Point C Contracted [320238]	$123 - $602	162%
Preferred Health Plan Contracted [320522]	$123 - $602	162%
Quik Trip Contracted [320447]	$123 - $602	162%
Reflect Health Contracted [320492]	$123 - $602	162%
Show-Me Health Administrators Contracted [320483]	$123 - $602	162%
United Medical Resources Contracted [320454]	$123 - $702	162%
Workers Comp [20426]	$123 - $602	162%
Yuzu Health Contracted [320521]	$123 - $602	162%
Globalhealth Contracted [320144]	$129 - $632	169%
Healthsmart Preferred Care Contracted [320184]	$158	207%
Kempton Contracted [320214]	$158	207%
First Health Contracted [320128]	$170 - $833	223%
Multiplan Contracted [320270]	$174 - $853	228%
Private Health Care Systems Contracted [320320]	$174 - $853	228%

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 $393.
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 Mercy Hospital Ada 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.