CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: Children's Hospital of Philadelphia

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 92507
Insurance Median: $283
Cash Discount Price: $673
vs. Medicare Baseline: 3.72x Medicare

The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at Children's Hospital of Philadelphia is $283. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $673. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 3.72x the Medicare baseline. Located in 3401 Civic Center Blvd, Philadelphia, PA.

Cash / Self-Pay

$673

Average discount available for prompt cash payment at this facility.

Insurance Median

$283

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: $673 (884%)

Insurance Median: $283 (372%)

Cash: $673 (884% of Medicare)

Ins. Median: $283 (372% 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 372% of the Medicare baseline (a markup of 272%). 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
Geisinger Medical Assistance	$29	38%
Horizon Nj Health	$70	92%
Medicaid / KanCare	$111	146%
UnitedHealthcare	$112 - $370	147%
Health Partners	$127	167%
Aetna	$177 - $337	232%
Highmark Wholecare	$184	242%
Upmc Medical Assistance	$184	242%
Keystone First Chip	$209	274%
Keystone Health Plan East	$213	280%
Blue Cross Blue Shield	$238 - $270	313%
Geisinger Health Plan Commercial	$296	389%
Jefferson Health Plans	$319	419%
Cigna	$337	443%
Highmark	$337	443%
Qualcare	$370	486%
First Health Network	$438	575%
Devon Health, Intergroup, Multiplan, Valley Preferred/Populytics	$539	708%
Private Health Care Systems	$539	708%
Choice Care Network	$606	796%

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 $673.
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 Children's Hospital of Philadelphia 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.