CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: UPMC Hamot

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 92507
Insurance Median: $110
Cash Discount Price: $180
vs. Medicare Baseline: 1.44x Medicare

The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at UPMC Hamot is $110. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $180. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 1.44x the Medicare baseline. Located in 201 State Street, Erie, PA.

Cash / Self-Pay

$180

Average discount available for prompt cash payment at this facility.

Insurance Median

$110

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: $180 (236%)

Insurance Median: $110 (144%)

Cash: $180 (236% of Medicare)

Ins. Median: $110 (144% 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 - $94	32%
UnitedHealthcare	$25 - $139	33%
Aetna	$26 - $210	34%
Geisinger	$30	39%
Highmark Wholecare (Prev Gateway)	$32 - $150	42%
Health Partners Plans (Jefferson Health Plan)	$33	43%
Amerihealth Caritas	$34	45%
Pa Health & Wellness	$37	49%
Univera	$45 - $132	59%
Blue Cross Blue Shield	$64 - $309	84%
Independent Health	$78 - $83	102%
Upmc Work Partners	$79	104%
Cigna	$90 - $120	118%
Intergroup	$195 - $240	256%
Multiplan	$210 - $240	276%

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 $180.
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 Hamot 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.