CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: UPMC Children's Hospital of Pittsburgh

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 92507
Insurance Median: $214
Cash Discount Price: $245
vs. Medicare Baseline: 2.81x Medicare

The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at UPMC Children's Hospital of Pittsburgh is $214. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $245. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 2.81x the Medicare baseline. Located in One Children's Hospital Drive, Pittsburgh, PA.

Cash / Self-Pay

$245

Average discount available for prompt cash payment at this facility.

Insurance Median

$214

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: $245 (322%)

Insurance Median: $214 (281%)

Cash: $245 (322% of Medicare)

Ins. Median: $214 (281% 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 281% of the Medicare baseline (a markup of 181%). 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	$50 - $233	66%
Aetna	$75 - $225	98%
Amerihealth Caritas	$81	106%
Health Partners Plans (Jefferson Health Plan)	$84	110%
UnitedHealthcare	$86 - $192	113%
Highmark Wholecare (Prev Gateway)	$88	116%
Pa Health & Wellness	$88	116%
Geisinger	$89 - $184	117%
Blue Cross Blue Shield	$182 - $273	239%
Cigna	$192 - $225	252%
Health Plan Of Upper Ohio Valley	$266	349%
Intergroup	$266 - $348	349%
Coventry/First Health	$327	429%
Saudi Armed Forces	$327	429%
Health Payors Organization	$348	457%
Multiplan	$348	457%
National Provider Network	$368	483%
Private Health Care Systems	$368	483%

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 $245.
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 Children's Hospital of Pittsburgh 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.