CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: Punxsutawney Area Hospital

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 92507
Insurance Median: $73
Cash Discount Price: $97
vs. Medicare Baseline: 0.96x Medicare

The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at Punxsutawney Area Hospital is $73. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $97. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 0.96x the Medicare baseline. Located in 81 Hillcrest Drive, Punxsutawney, PA.

Cash / Self-Pay

$97

Average discount available for prompt cash payment at this facility.

Insurance Median

$73

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: $97 (127%)

Insurance Median: $73 (96%)

Cash: $97 (127% of Medicare)

Ins. Median: $73 (96% 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.

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
Amerihealth Caritas	$24 - $72	32%
Highmark Wholecare	$24 - $73	32%
UnitedHealthcare	$24 - $100	32%
Upmc Health Plan	$25 - $166	33%
Ambetter / Centene	$29 - $77	38%
Geisinger Health Plan	$29 - $74	38%
Tricare	$65	85%
Highmark	$67 - $196	88%
Aetna	$72 - $162	95%
Humana	$72	95%
United Mine Workers Of America	$73	96%
Cigna	$74 - $149	97%
Pa Health And Wellness Commercial	$92 - $147	121%
Geisinger	$103	135%
Pa Workers Compensation	$251	330%

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 $97.
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 Punxsutawney Area 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.