CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: Cook Childrens Medical Center Prosper

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 92507
Insurance Median: $211
Cash Discount Price: $343
vs. Medicare Baseline: 2.77x Medicare

The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at Cook Childrens Medical Center Prosper is $211. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $343. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 2.77x the Medicare baseline. Located in 4100 W University Drive, Prosper, TX.

Cash / Self-Pay

$343

Average discount available for prompt cash payment at this facility.

Insurance Median

$211

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: $343 (450%)

Insurance Median: $211 (277%)

Cash: $343 (450% of Medicare)

Ins. Median: $211 (277% 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 277% of the Medicare baseline (a markup of 177%). 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
Health Plan W. Uhrip	$91 - $152	120%
Health Plan W/O Uhrip	$91 - $247	120%
Aetna	$129 - $389	169%
Superior Health	$152	200%
Wellpoint	$160	210%
Blue Cross Blue Shield	$164 - $412	215%
United Community	$169 - $201	222%
UnitedHealthcare	$201 - $389	264%
Beacon	$211 - $247	277%
El Paso Health First	$211 - $247	277%
Tx Children Health	$211 - $247	277%
Firstcare	$221 - $366	290%
S&W Health	$384	504%
Cigna	$389	511%
Healthscope	$389	511%
Imagine Health	$389	511%
Humana	$398 - $403	523%
Multiplan	$398	523%
First Health	$403	529%
Galaxy Health	$412	541%
Healthsmart	$412	541%
Usamco	$421	553%

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 $343.
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 Cook Childrens Medical Center Prosper 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.