CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: Astria Sunnyside Hospital

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 92507
Insurance Median: $351
Cash Discount Price: $381
vs. Medicare Baseline: 4.61x Medicare

The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at Astria Sunnyside Hospital is $351. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $381. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 4.61x the Medicare baseline. Located in 1016 Tacoma Avenue, Sunnyside, WA.

Cash / Self-Pay

$381

Average discount available for prompt cash payment at this facility.

Insurance Median

$351

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: $381 (500%)

Insurance Median: $351 (461%)

Cash: $381 (500% of Medicare)

Ins. Median: $351 (461% 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 461% of the Medicare baseline (a markup of 361%). 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
Medicare (plans)	$89 - $172	117%
Aetna	$161 - $600	211%
Healthcomp_Ihs	$161 - $167	211%
Humana	$161 - $614	211%
Medicaid / KanCare	$161 - $209	211%
Molina	$161 - $167	211%
Va	$161 - $167	211%
Tricare	$162 - $169	213%
Regence	$337 - $351	443%
Cigna	$394 - $409	517%
Li	$403 - $419	529%
First_Choice	$492 - $512	646%
Tpsc	$512 - $532	672%
Kaiser	$515 - $536	676%
Premera	$534 - $555	701%
UnitedHealthcare	$558 - $580	733%
Fhpw	$577 - $600	758%
Healthcomp	$590 - $614	775%
Bcchp	$656 - $682	861%
Great_Rivers	$656 - $682	861%
Zenith	$656 - $682	861%

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 $381.
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 Astria Sunnyside 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.