CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: Mercy Hospital Tishomingo Inc

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 92507
  • Insurance Median: $347
  • Cash Discount Price: $398
  • vs. Medicare Baseline: 4.56x Medicare
The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at Mercy Hospital Tishomingo Inc is $347. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $398. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 4.56x the Medicare baseline. Located in 1000 South Byrd St, Tishomingo, OK.
Cash / Self-Pay
$398

Average discount available for prompt cash payment at this facility.

Insurance Median
$347

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: $398 (523%)
Insurance Median: $347 (456%)
Cash: $398 (523% of Medicare)
Ins. Median: $347 (456% 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 456% of the Medicare baseline (a markup of 356%). 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
Ambetter / Centene $58 - $309 76%
Home State Health Plan Contracted [320187] $58 - $309 76%
Medicaid / KanCare $58 - $309 76%
Novasys Contracted [320285] $58 - $309 76%
Blue Cross Blue Shield $62 - $496 81%
Aetna $68 - $686 89%
Humana $68 - $825 89%
Webtpa Contracted [320417] $81 - $433 106%
Medicare (plans) $89 - $660 117%
Cherokee Nation Health Serv Contracted [320066] $93 - $496 122%
Cross Timbers Hospice [20098] $93 - $496 122%
Dept Of Veteran Affairs Contracted [320106] $93 - $496 122%
Elara Caring Aspire Hospice Contracted [320433] $93 - $496 122%
Elara Caring Aspire Hospice [20433] $93 - $496 122%
Halo Hcr Inc Hospice Contracted [320432] $93 - $496 122%
Halo Hcr Inc Hospice [20432] $93 - $496 122%
Independent Health [20197] $93 - $496 122%
Indian Health Service Contracted [320198] $93 - $496 122%
Kindful Hospice Contracted [320434] $93 - $496 122%
Kindful Hospice [20434] $93 - $496 122%
Medical Associates Health [20444] $93 - $496 122%
Mercy Hospice Okc [20252] $93 - $496 122%
Provider Partners Health Plans Contracted [320450] $93 - $496 122%
Qual Choice Contracted [320325] $93 - $496 122%
Tribute Health Plan Mcr Contracted [320338] $93 - $496 122%
Tricare $93 - $496 122%
UnitedHealthcare $93 - $813 122%
Globalhealth Contracted [320145] $95 - $506 125%
Cigna $96 - $773 126%
Aither Health Contracted [320449] $116 - $876 152%
Mercy Benefit Admin Contracted [320251] $116 - $876 152%
Quik Trip Contracted [320447] $116 - $619 152%
Show-Me Health Administrators Contracted [320483] $116 - $619 152%
Health Choice Contracted [320166] $119 156%
Medica Contracted [320239] $124 - $660 163%
First Health Contracted [320128] $128 - $686 168%
Osma Health Contracted [320292] $135 - $722 177%
Benefit Management Contracted [320052] $145 - $928 190%
Healthcare Highways Plus Contracted [320175] $145 - $773 190%
Private Health Care Systems Contracted [320320] $145 - $825 190%
United Medical Resources Contracted [320454] $152 - $813 200%
Multiplan Contracted [320270] $154 - $928 202%
Auxiant Contracted [320462] $164 - $876 215%
Ebms Contracted [320493] $164 - $876 215%
Healthlink Contracted [320179] $164 - $876 215%
Imagine 360 Contracted [320494] $164 - $876 215%
Preferred Community Choice Contracted [320311] $164 - $876 215%
Reflect Health Contracted [320492] $164 - $876 215%
Yuzu Health Contracted [320521] $164 - $876 215%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1000 South Byrd St, Tishomingo, OK 73460
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Critical Access Hospitals