CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: UT Health East Texas Athens Hospital

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 92507
Insurance Median: $83
Cash Discount Price: $27
vs. Medicare Baseline: 1.09x Medicare

The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at UT Health East Texas Athens Hospital is $83. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $27. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 1.09x the Medicare baseline. Located in 2000 South Palestine St, Athens, TX.

Cash / Self-Pay

$27

Average discount available for prompt cash payment at this facility.

Insurance Median

$83

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: $27 (35%)

Insurance Median: $83 (109%)

Cash: $27 (35% of Medicare)

Ins. Median: $83 (109% 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	$24 - $83	32%
Amerigroup Commercial [5055]	$68	89%
Black Lung [6055]	$68	89%
Healthcare Highways [2210]	$68	89%
Healthscope Benefits [2290]	$68	89%
Lucent Health [6000]	$68	89%
Web Tpa [2115]	$68 - $171	89%
Blue Cross Blue Shield	$83	109%
Cigna	$83 - $152	109%
Parkland Community Health Plan [6015]	$83	109%
UnitedHealthcare	$83	109%
Andrews Center Behavioral Health [3950]	$136	179%
Healthfirst [2395]	$136	179%
Aetna	$171	225%
Mailhandlers [1595]	$171	225%

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 $27.
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 UT Health East Texas Athens Hospital 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.