CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: Douglas County Memorial Hospital-Cah

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 92507
Insurance Median: $1,367
Cash Discount Price: $1,259
vs. Medicare Baseline: 17.95x Medicare

The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at Douglas County Memorial Hospital-Cah is $1,367. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,259. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 17.95x the Medicare baseline. Located in 708 8Th St, Armour, SD.

Cash / Self-Pay

$1,259

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,367

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: $1,259 (1653%)

Insurance Median: $1,367 (1795%)

Cash: $1,259 (1653% of Medicare)

Ins. Median: $1,367 (1795% 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 1795% of the Medicare baseline (a markup of 1695%). 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
Sanford Health Plan	$86 - $1,396	113%
UnitedHealthcare	$1,223	1606%
Avera Health	$1,367	1795%
Blue Cross Blue Shield	$1,439	1890%

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 $1,259.
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 Douglas County Memorial Hospital-Cah 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.