CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: UPMC Passavant

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 92507
  • Insurance Median: $157
  • Cash Discount Price: $203
  • vs. Medicare Baseline: 2.06x Medicare
The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at UPMC Passavant is $157. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $203. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 2.06x the Medicare baseline. Located in 9100 Babcock Boulevard, Pittsburgh, PA.
Cash / Self-Pay
$203

Average discount available for prompt cash payment at this facility.

Insurance Median
$157

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: $203 (267%)
Insurance Median: $157 (206%)
Cash: $203 (267% of Medicare)
Ins. Median: $157 (206% 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 206% of the Medicare baseline (a markup of 106%). 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
Upmc Health Plan $24 - $272 32%
UnitedHealthcare $25 33%
Highmark Wholecare (Prev Gateway) $32 - $170 42%
Amerihealth Caritas $34 45%
Pa Health & Wellness $37 49%
Blue Cross Blue Shield $64 - $300 84%
Upmc Work Partners $79 104%
Aetna $85 112%
Private Health Care Systems $92 - $315 121%
Cigna $115 - $136 151%
Health Plan Of Upper Ohio Valley $157 206%
Coventry/First Health $237 311%
Intergroup $281 - $305 369%
Humana $288 - $315 378%
Multiplan $288 - $315 378%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 9100 Babcock Boulevard, Pittsburgh, PA 15237
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals