CMS Price Transparency Data
Speech therapy (language evaluation)
Facility: Saint Alphonsus Medical Center Ontario
Billing Code: 92507 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 92507
- Insurance Median: $117
- Cash Discount Price: $253
- vs. Medicare Baseline: 1.54x Medicare
The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at Saint Alphonsus Medical Center Ontario is $117. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $253. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 1.54x the Medicare baseline. Located in 351 Sw 9Th Street, Ontario, OR.
Cash / Self-Pay
$253
Average discount available for prompt cash payment at this facility.
Insurance Median
$117
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: $253 (332%)
Insurance Median: $117 (154%)
Cash: $253 (332% of Medicare)
Ins. Median: $117 (154% 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.
Out-of-Pocket Cost Estimator
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Medicaid / KanCare | $66 - $117 | 87% |
| Blue Cross Blue Shield | $75 - $331 | 98% |
| Medicare (plans) | $75 - $80 | 98% |
| UnitedHealthcare | $75 - $373 | 98% |
| Aetna | $77 - $368 | 101% |
| American Health Advantage Of Idaho | $78 | 102% |
| Ada County Jail Inmate Ins | $117 | 154% |
| Ambetter / Centene | $117 | 154% |
| Amish Mennonite | $117 | 154% |
| Bcccp-Michigan | $117 | 154% |
| Bccp | $117 | 154% |
| Bmc Healthnet | $117 | 154% |
| Breast Grant-Connecticut | $117 | 154% |
| California Health And Wellness | $117 | 154% |
| Cardinal Innovations Lme | $117 | 154% |
| Care Oregon Ohp | $117 | 154% |
| Cencal Health Plan | $117 | 154% |
| Cenpatico | $117 | 154% |
| Centurion Of Idaho | $117 | 154% |
| Chhuny | $117 | 154% |
| Childrens Comm Health Plan | $117 | 154% |
| Childrens Medical Services Title 19 | $117 | 154% |
| Cigna | $117 - $366 | 154% |
| Community Benefit Health | $117 | 154% |
| Community Care Behavorial Health | $117 | 154% |
| Community Health Choice | $117 | 154% |
| Covid19 Hrsa Uninsured Testing And Treatment Fund | $117 | 154% |
| Dean Wi Badgercare | $117 | 154% |
| Delaware First Health | $117 | 154% |
| Delta Dental Nj | $117 | 154% |
| Dph Tb Program | $117 | 154% |
| Dscc | $117 | 154% |
| Eastpointe Lme | $117 | 154% |
| Family Health Network | $117 | 154% |
| Freedom First Healthcare | $117 | 154% |
| Ghc Scw Wi Badgercare | $117 | 154% |
| Harbor Health | $117 | 154% |
| Health Safety Net | $117 | 154% |
| Healthy Blue Ne | $117 | 154% |
| Hennepin Health | $117 | 154% |
| Humana | $117 - $342 | 154% |
| Id County Ada | $117 | 154% |
| Id County Canyon | $117 | 154% |
| Id County Cat Fund | $117 | 154% |
| Id County Payette | $117 | 154% |
| Idaho Womens Health Check | $117 | 154% |
| Indiana Breast Cervical Cancer | $117 | 154% |
| Inland Empire Health Plan | $117 | 154% |
| Intercommunity Health Ohp | $117 | 154% |
| Iowa Total Care | $117 | 154% |
| Jai Medical System | $117 | 154% |
| Kern Family Health Plan | $117 | 154% |
| Keystone First | $117 | 154% |
| Keystone First Chip | $117 | 154% |
| La Care Health Plan | $117 | 154% |
| Lakeland Care Inc | $117 | 154% |
| Managed Health Services - Indiana | $117 | 154% |
| Maryland Breast & Cervical Program | $117 | 154% |
| Maryland Healthy Smiles - Scion Dental | $117 | 154% |
| Maryland Physicians Care | $117 | 154% |
| Massachusetts Behavioral Health Partnership | $117 | 154% |
| Mdwise | $117 | 154% |
| Medi-Cal | $117 | 154% |
| Medi-Cal Healthnet | $117 | 154% |
| Medstar Dc Healthy Family | $117 | 154% |
| Medstar Md Health Choice | $117 | 154% |
| Mo Home State Health Plan | $117 | 154% |
| Molina Centennial Care | $117 | 154% |
| Nascentia Health Options | $117 | 154% |
| Nebraska Total Care | $117 | 154% |
| New York Cancer Services Program | $117 | 154% |
| Nextlevel Health | $117 | 154% |
| Oregon Screenwise | $117 | 154% |
| Pace Of Southwest Michigan | $117 | 154% |
| Paramount Advantage | $117 | 154% |
| Parkland Community Health Plan | $117 | 154% |
| Partners Behavioral Lme | $117 | 154% |
| Peach State Healthplan | $117 | 154% |
| Presbyterian Centennial Care | $117 | 154% |
| Prestige Health Choice | $117 | 154% |
| Priority Partners | $117 | 154% |
| Rx 340B Pass Along | $117 | 154% |
| Rx Assistance/Rx Manufacturer Assistance 0 Copay | $117 | 154% |
| Rx Medi-Cal | $117 | 154% |
| Rx Meridian Rx | $117 | 154% |
| Sandhills Center Lme | $117 | 154% |
| Screening For Life | $117 | 154% |
| Sunshine State Health Plan | $117 | 154% |
| Superior Health | $117 | 154% |
| Tenncare | $117 | 154% |
| Texas Children'S Health Plan | $117 | 154% |
| Trillium Community Ohp | $117 | 154% |
| Tufts Health Public Plans | $117 | 154% |
| Vaya Health Lme | $117 | 154% |
| Wellsense Health Plan | $117 | 154% |
| Wi Womens Wellness | $117 | 154% |
| Blue Benefit Administrators Of Massachusetts | $120 | 158% |
| Blue Care Network | $120 | 158% |
| Blue Distinction Transplant | $120 | 158% |
| Blue Shield - Ca | $120 | 158% |
| Blue Shield - Id (Regence) | $120 | 158% |
| Blue Shield - Ny Highmark Northeastern | $120 | 158% |
| Blue Shield - Ny Highmark Western | $120 | 158% |
| Blue Shield - Pa (Highmark) | $120 | 158% |
| Blue Shield - Wa (Regence) | $120 | 158% |
| Healthcare Management Admin | $127 | 167% |
| Moda Health | $143 - $377 | 188% |
| Selecthealth | $144 - $350 | 189% |
| Webtpa | $201 - $350 | 264% |
| Mountain Health Co-Op | $233 | 306% |
| Pacificsource Health Plans | $233 - $366 | 306% |
| Allegiance | $296 | 389% |
| Correctional Health Partners | $303 | 398% |
| Columbia Health Network | $311 | 408% |
| Healthnet | $327 | 429% |
| Allied National Global Care | $350 | 460% |
| Asrm - Reliance Standard Life Insurance | $350 | 460% |
| Christian Care Ministry | $350 | 460% |
| Dean Health | $350 | 460% |
| Fallon Health | $350 | 460% |
| Family Life Insurance Company | $350 | 460% |
| First Choice Health | $350 | 460% |
| Ghc Scw | $350 | 460% |
| International Benefit Administrators | $350 | 460% |
| Lifetime Benefit Solutions | $350 | 460% |
| Manhattan Life | $350 | 460% |
| Pai | $350 | 460% |
| Pan-American Life | $350 | 460% |
| Paramount Hmo | $350 | 460% |
| Phcs | $350 | 460% |
| Trinity Health Share | $350 | 460% |
| Lifewise | $362 | 475% |
| Priority Health | $366 | 481% |
| Allied Benefit Systems | $368 | 483% |
| Ameriben | $368 | 483% |
| Asr Health Benefits | $368 | 483% |
| Christian Brother Services | $368 | 483% |
| Geha | $368 - $373 | 483% |
| Healthez | $368 | 483% |
| Luminare Health (Detroit) | $368 | 483% |
| Rural Carrier Health Benefit Plan | $368 | 483% |
| First Health | $370 | 486% |
| Medi Share | $370 | 486% |
| Providence | $370 | 486% |