CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: Clarion Hospital

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 92507
  • Insurance Median: $81
  • Cash Discount Price: $114
  • vs. Medicare Baseline: 1.06x Medicare
The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at Clarion Hospital is $81. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $114. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 1.06x the Medicare baseline. Located in One Hospital Drive, Clarion, PA.
Cash / Self-Pay
$114

Average discount available for prompt cash payment at this facility.

Insurance Median
$81

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: $114 (150%)
Insurance Median: $81 (106%)
Cash: $114 (150% of Medicare)
Ins. Median: $81 (106% 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.

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
Medicaid / KanCare $22 29%
Amerihealth $24 - $73 32%
Jefferson Health Plan $24 32%
Geisinger $26 - $76 34%
Upmc $27 - $147 35%
Highmark $61 - $120 80%
Highmark - Ind.& Managed Care $61 - $163 80%
Martin'S Point - Usfhp $63 - $80 83%
Gateway $67 - $84 88%
Devoted Health Plan $72 - $91 95%
Highmark Community Blue $72 95%
Cigna $73 - $114 96%
Medicare (plans) $73 96%
Tricare $73 96%
UnitedHealthcare $73 96%
Aetna $75 - $203 98%
The Health Plan $77 - $171 101%
Pa Health & Wellness $78 102%
American Health Plan $80 105%
Workers Comp $85 112%
Peak Health $126 - $171 165%
Devon $135 - $171 177%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: One Hospital Drive, Clarion, PA 16214
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals