CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: Lancaster General Hospital

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 92507
  • Insurance Median: $179
  • Cash Discount Price: $213
  • vs. Medicare Baseline: 2.35x Medicare
The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at Lancaster General Hospital is $179. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $213. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 2.35x the Medicare baseline. Located in 555 North Duke Street, Lancaster, PA.
Cash / Self-Pay
$213

Average discount available for prompt cash payment at this facility.

Insurance Median
$179

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: $213 (280%)
Insurance Median: $179 (235%)
Cash: $213 (280% of Medicare)
Ins. Median: $179 (235% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 235% of the Medicare baseline (a markup of 135%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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 - $142 29%
UnitedHealthcare $24 - $186 32%
Gateway $25 33%
Upmc For You $37 49%
Hospice And Community Care $40 - $42 53%
Old Order Group $57 - $70 75%
Lg Coresource/Lg Eliance $60 - $62 79%
Lancashire Hall $63 - $219 83%
Nursing Home Op Services $63 - $66 83%
Tricare $65 85%
Blue Cross Blue Shield $69 - $405 91%
Highmark $72 - $219 95%
Aetna $73 - $148 96%
Albright Life $73 96%
Coatesville Va $73 96%
Hospice Generic $73 96%
Lebanon Veterans Hospital $73 96%
Medicare (plans) $73 - $80 96%
Amerihealth Caritas $74 97%
Cigna $75 - $183 98%
Health Partners Mcr Advantage $75 98%
Devoted Health $76 100%
Pa Health And Wellness Mcr $76 100%
Affilia Home Health $84 - $219 110%
Masonic Homes $89 - $219 117%
Elap Employees $103 135%
Eliance Health Solutions $135 - $140 177%
Highmark Commercial Preferred $141 - $219 185%
Oscar Health Plan $142 186%
Ehp $173 - $180 227%
Upmc Commercial $173 - $186 227%
Devon $179 - $186 235%
Geisinger Commercial $179 - $186 235%
Intergroup Services $179 - $186 235%
Preferred Healthcare $179 - $186 235%
Medi-Share Christian Care $200 - $208 263%
Commercial Generic $211 - $219 277%
Highmark Commercial Non-Preferred $211 - $221 277%
Magellan $211 - $219 277%
United Behavioral Health $211 - $219 277%
Value Options $211 - $219 277%
Workers Compensation $211 - $219 277%
Claim Watcher Plus $218 286%
Claim Watcher $240 315%
Elap Other Groups $264 347%
Gift Of Life Donor Program $13,500 17728%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 555 North Duke Street, Lancaster, PA 17602
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals