CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: Lower Bucks Hospital

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 92507
Insurance Median: $82
Cash Discount Price: $78
vs. Medicare Baseline: 1.08x Medicare

The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at Lower Bucks Hospital is $82. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $78. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 1.08x the Medicare baseline. Located in 501 Bath Road, Bristol, PA.

Cash / Self-Pay

$78

Average discount available for prompt cash payment at this facility.

Insurance Median

$82

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: $78 (102%)

Insurance Median: $82 (108%)

Cash: $78 (102% of Medicare)

Ins. Median: $82 (108% 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
Health Partners Plan	$22 - $118	29%
Medicaid / KanCare	$22	29%
Keystone	$23 - $81	30%
UnitedHealthcare	$25 - $86	33%
Humana	$63	83%
Blue Cross Blue Shield	$78 - $245	102%
Medicare (plans)	$78 - $82	102%
Pa Health & Wellness	$78 - $94	102%
Tricare	$78	102%
Provider Patners Health Plan	$81	106%
Spartan Plan Pa	$82	108%
Auto Insurance	$86	113%
Worker Compensation	$89	117%
Employer Direct Healthcare	$110	144%
Highmark	$166	218%
Cigna	$180	236%

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 $78.
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 Lower Bucks Hospital 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.