CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: UPMC Horizon

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 92507
Insurance Median: $251
Cash Discount Price: $383
vs. Medicare Baseline: 3.30x Medicare

The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at UPMC Horizon is $251. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $383. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 3.30x the Medicare baseline. Located in 110 North Main Street, Greenville, PA.

Cash / Self-Pay

$383

Average discount available for prompt cash payment at this facility.

Insurance Median

$251

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: $383 (503%)

Insurance Median: $251 (330%)

Cash: $383 (503% of Medicare)

Ins. Median: $251 (330% 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 330% of the Medicare baseline (a markup of 230%). 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
UnitedHealthcare	$23 - $256	30%
Aetna	$24 - $383	32%
Upmc Health Plan	$24 - $251	32%
Geisinger	$30	39%
Highmark Wholecare (Prev Gateway)	$32 - $320	42%
Health Partners Plans (Jefferson Health Plan)	$33	43%
Amerihealth Caritas	$34	45%
Pa Health & Wellness	$37	49%
Upmc Work Partners	$75	98%
Blue Cross Blue Shield	$103 - $320	135%
Cigna	$249 - $256	327%
Intergroup	$415	545%
Coventry/First Health	$422	554%
Health Coalition Partners	$447	587%
Private Health Care Systems	$511	671%
Prime Net	$524	688%
Humana	$543	713%

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 $383.
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 Horizon 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.