CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: Prisma Health Tuomey Hospital

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 92507
  • Insurance Median: $112
  • Cash Discount Price: $242
  • vs. Medicare Baseline: 1.47x Medicare
The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at Prisma Health Tuomey Hospital is $112. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $242. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 1.47x the Medicare baseline. Located in 129 N Washington St, Sumter, SC.
Cash / Self-Pay
$242

Average discount available for prompt cash payment at this facility.

Insurance Median
$112

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: $242 (318%)
Insurance Median: $112 (147%)
Cash: $242 (318% of Medicare)
Ins. Median: $112 (147% 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.

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 $23 - $92 30%
UnitedHealthcare $23 - $395 30%
Prisma Health Seniorcare Pace - Midlands [5400] $35 - $138 46%
Prisma Health Seniorcare Pace-Upstate [5200] $35 - $138 46%
Blue Cross Blue Shield $46 - $226 60%
Bluechoice [810] $46 - $226 60%
Promise Health Plan Contracted [2401] $52 - $358 68%
Orangeburg Senior Helping Center Pace [5401] $60 - $238 79%
Humana $69 - $447 91%
Cigna $74 - $510 97%
Covid19 Hrsa Uninsured Testing & Treatment Fund [904] $74 97%
Medicare (plans) $74 - $77 97%
Tricare $74 97%
Triwest Healthcare Alliance Vcp [902] $74 97%
Va Community Care Network-Vaccn [903] $74 97%
Aetna $77 - $471 101%
Healthy Conn Prime-First Choice Vip Care [5300] $77 101%
Healthy Conn Prime-Molina Healthcare [5330] $77 101%
Healthy Conn Prime-Wellcare Prime By Atc [5310] $77 101%
Bob Jones Univ-Pai [821] $89 - $358 117%
Meritain Health Contracted [2200] $95 - $471 125%
Workers Comp [600] $103 135%
Preferred Administrators Contracted [2839] $104 - $417 137%
Medcost [2940] $110 - $495 144%
Atlantic Packaging Contracted [4833] $112 - $447 147%
Aps Healthcare System [2981] $119 - $477 156%
Scdc-Sc Dept Of Corrections [7232] $128 168%
Multiplan/Phcs Contracted [2950] $133 - $530 175%
Vsp Vision Care [2986] $134 - $536 176%
Ambetter / Centene $136 179%
First Health Contracted [2952] $139 - $554 183%
Furman Int/Allen University Student [2951] $139 - $554 183%
Quiktrip-First Health [3067] $139 - $554 183%
Planned Administrators [820] $226 297%
Golden Rule Insurance Company [2991] $395 519%
Oxford Health Plans [2992] $395 519%
Zzumr-Salt Lake City Ut [3169] $395 519%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 129 N Washington St, Sumter, SC 29150
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals