CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: UPMC Mercy

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 92507
Insurance Median: $128
Cash Discount Price: $190
vs. Medicare Baseline: 1.68x Medicare

The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at UPMC Mercy is $128. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $190. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 1.68x the Medicare baseline. Located in 1400 Locust Street, Pittsburgh, PA.

Cash / Self-Pay

$190

Average discount available for prompt cash payment at this facility.

Insurance Median

$128

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: $190 (250%)

Insurance Median: $128 (168%)

Cash: $190 (250% of Medicare)

Ins. Median: $128 (168% 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

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
Upmc Health Plan	$24 - $188	32%
UnitedHealthcare	$25	33%
Highmark Wholecare (Prev Gateway)	$32 - $158	42%
Amerihealth Caritas	$34	45%
Pa Health & Wellness	$37	49%
Blue Cross Blue Shield	$64 - $131	84%
Upmc Work Partners	$78	102%
Aetna	$79 - $127	104%
Cigna	$108 - $190	142%
Bravo	$111	146%
Coventry/First Health	$139	183%
Intergroup	$158 - $254	207%
Private Health Care Systems	$238	313%
American Healthcare Group	$254	334%
National Provider Network	$260	341%
Health Payors Organization	$285	374%
Multiplan	$285	374%

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 $190.
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 UPMC Mercy 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.