CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: Matagorda Regional Medical Center

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 92507
Insurance Median: $178
Cash Discount Price: $127
vs. Medicare Baseline: 2.34x Medicare

The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at Matagorda Regional Medical Center is $178. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $127. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 2.34x the Medicare baseline. Located in 104 7Th Street, Bay City, TX.

Cash / Self-Pay

$127

Average discount available for prompt cash payment at this facility.

Insurance Median

$178

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: $127 (167%)

Insurance Median: $178 (234%)

Cash: $127 (167% of Medicare)

Ins. Median: $178 (234% 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 234% of the Medicare baseline (a markup of 134%). 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
Comm Care	$142	186%
Medicaid / KanCare	$142	186%
Molina	$142	186%
Scott & White	$142	186%
Superior	$142	186%
Tcstar	$142	186%
UnitedHealthcare	$142 - $176	186%
Wellpoint	$142	186%
Aetna	$159	209%
Humana	$165	217%
Coventry First Health	$178	234%
Galaxy Health	$178	234%
Cigna	$190	250%
Blue Cross Blue Shield	$210 - $254	276%
Independent Medical System	$216	284%
Multiplan Phcs	$216	284%
Three Rivers	$216	284%
Health Smart	$229	301%
Usa Managed	$229	301%

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 $127.
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 Matagorda Regional Medical Center 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.