CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: Pottstown Hospital

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 92507
Insurance Median: $359
Cash Discount Price: $136
vs. Medicare Baseline: 4.71x Medicare

The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at Pottstown Hospital is $359. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $136. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 4.71x the Medicare baseline. Located in 1600 East High Street, Pottstown, PA.

Cash / Self-Pay

$136

Average discount available for prompt cash payment at this facility.

Insurance Median

$359

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: $136 (179%)

Insurance Median: $359 (471%)

Cash: $136 (179% of Medicare)

Ins. Median: $359 (471% 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 471% of the Medicare baseline (a markup of 371%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Geisinger	$26	34%
Health Partners	$27	35%
Pa Health And Wellness	$27	35%
Gateway	$30	39%
Upmc	$30 - $614	39%
Aetna	$37	49%
Keystone First	$49 - $293	64%
Blue Cross Blue Shield	$109 - $652	143%
First Health	$123 - $737	162%
Cigna	$125	164%
Devon	$134 - $803	176%

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 $136.
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 Pottstown 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.