CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: UPMC Presbyterian Shadyside

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 92507
Insurance Median: $275
Cash Discount Price: $236
vs. Medicare Baseline: 3.61x Medicare

The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at UPMC Presbyterian Shadyside is $275. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $236. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 3.61x the Medicare baseline. Located in 200 Lothrop Street, Pittsburgh, PA.

Cash / Self-Pay

$236

Average discount available for prompt cash payment at this facility.

Insurance Median

$275

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: $236 (310%)

Insurance Median: $275 (361%)

Cash: $236 (310% of Medicare)

Ins. Median: $275 (361% 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 361% of the Medicare baseline (a markup of 261%). 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
Upmc Health Plan	$24 - $303	32%
UnitedHealthcare	$26	34%
Aetna	$28 - $98	37%
Highmark Wholecare (Prev Gateway)	$32 - $196	42%
Health Partners Plans (Jefferson Health Plan)	$33	43%
Amerihealth Caritas	$34	45%
Geisinger	$34	45%
Pa Health & Wellness	$37	49%
Blue Cross Blue Shield	$64 - $287	84%
Upmc Work Partners	$78	102%
Multiplan	$91 - $314	120%
Preferred Healthcare System	$255	335%
Coventry/First Health	$275	361%
Fidelis	$295	387%
Intergroup	$295 - $334	387%
Health Coalition Partners	$314	412%
Private Health Care Systems	$314	412%
Selectcare	$314	412%
Health Payors Organization	$334	439%
Humana	$334	439%

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 $236.
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 UPMC Presbyterian Shadyside 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.