CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: St Mary Medical Center

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 92507
Insurance Median: $142
Cash Discount Price: $281
vs. Medicare Baseline: 1.86x Medicare

The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at St Mary Medical Center is $142. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $281. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 1.86x the Medicare baseline. Located in Langhorne-Newtown Rd, Langhorne, PA.

Cash / Self-Pay

$281

Average discount available for prompt cash payment at this facility.

Insurance Median

$142

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: $281 (369%)

Insurance Median: $142 (186%)

Cash: $281 (369% of Medicare)

Ins. Median: $142 (186% 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
Medicaid / KanCare	$25 - $63	33%
Aetna	$31 - $384	41%
UnitedHealthcare	$36 - $229	47%
Keystone First	$52	68%
Keystone First Chip	$52	68%
Pace-Trinity Health	$56	74%
Blue Cross Blue Shield	$79 - $186	104%
Cigna	$79 - $358	104%
Align Senior Care	$80	105%
Medicare (plans)	$81 - $142	106%
Health America Advantra	$94	123%
Ambetter / Centene	$141	185%
Oscar	$142	186%
Prime Healthcare	$142	186%
Jefferson Health Plan Commercial	$143	188%
Homestead Health Plans Woods Center	$154	202%
Group Pension Administrators	$177	232%
Reedman Toll	$177	232%
Amerihealth	$186	244%
Blue Shield - Ca	$186	244%
Blue Shield - Id (Regence)	$186	244%
Blue Shield - Ny Highmark Western	$186	244%
Blue Shield - Wa (Regence)	$186	244%
Blue Shield - Pa (Highmark)	$213	280%
Geha	$229	301%
Upmc Health Plan	$358	470%
Webtpa	$358	470%
Meritain	$384	504%
Multiplan	$389	511%
Prime Health Services	$389	511%
Galaxy Health Network	$410	538%
Three Rivers Provider Network	$410	538%

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 $281.
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 St Mary Medical Center 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.