CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: North Austin Medical Center

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 92507
  • Insurance Median: $186
  • Cash Discount Price: $867
  • vs. Medicare Baseline: 2.44x Medicare
The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at North Austin Medical Center is $186. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $867. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 2.44x the Medicare baseline. Located in 12221 Mopac Expressway North, Austin, TX.
Cash / Self-Pay
$867

Average discount available for prompt cash payment at this facility.

Insurance Median
$186

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: $867 (1139%)
Insurance Median: $186 (244%)
Cash: $867 (1139% of Medicare)
Ins. Median: $186 (244% 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 244% of the Medicare baseline (a markup of 144%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Amerigroup $34 45%
Superior Health Plan $43 - $147 56%
Triwest Health Alliance $76 100%
Wellmed $76 100%
Aetna $78 - $502 102%
Blue Cross Blue Shield $78 - $462 102%
Cigna $78 102%
Devoted Health $78 102%
Humana $78 102%
Odyssey Hospice $78 102%
St David’S Hospice $78 102%
Triwest Healthcare Alliance $78 102%
UnitedHealthcare $78 - $390 102%
United $80 - $390 105%
American Health Plan Of Texas $82 108%
Shared Health $82 108%
Provider Partners Health Plan $83 109%
Texas Independent Health Plan $83 109%
Wellcare $83 109%
Pyramid Life $84 110%
Molina Healthcare $85 112%
Imperial Insurance $86 113%
Universal Health $94 123%
Austin Fc $98 129%
Sendero $105 - $134 138%
Naphcare $121 159%
Seven Corners $121 159%
Corvel Corporation $155 204%
Oscar $166 - $186 218%
Moda $204 268%
Covenant Management Systems $250 328%
Healthcare Highways $252 - $260 331%
Imo Med - Select Network $260 341%
Moda Health $312 - $321 410%
Texas Healthcare Foundation Heb $321 422%
Texas Workforce Commission $338 444%
Averde Health $390 512%
Comanche County $434 570%
National Choicecare $434 570%
Healthsmart Preferred Care $477 - $694 626%
Independent Medical Systems $477 626%
Physicians Cooperative Of Texas $477 626%
Prime Health $520 683%
First Health $542 - $616 712%
Coastal Comp Health Networks $564 741%
National Health Care $564 741%
Texas Municipal League $607 797%
Medcorp Southwest $650 854%
Rockport Healthcare Group $694 - $780 911%
Bce Emergis Corporation $780 1024%
Beech Street $780 1024%
Medical Control Network Solutions $780 1024%
Multiplan $780 1024%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 12221 Mopac Expressway North, Austin, TX 78758
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals