CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: University of Wi Hospitals & Clinics Authority

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 92507
  • Insurance Median: $280
  • Cash Discount Price: $263
  • vs. Medicare Baseline: 3.68x Medicare
The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at University of Wi Hospitals & Clinics Authority is $280. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $263. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 3.68x the Medicare baseline. Located in 600 Highland Avenue, Madison, WI.
Cash / Self-Pay
$263

Average discount available for prompt cash payment at this facility.

Insurance Median
$280

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: $263 (345%)
Insurance Median: $280 (368%)
Cash: $263 (345% of Medicare)
Ins. Median: $280 (368% 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 368% of the Medicare baseline (a markup of 268%). 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
Medicare (plans) $132 - $307 173%
Alliance_Premier_Network $210 276%
Mercycare $218 286%
Triology $224 - $268 294%
Security_Health_Plan $237 - $279 311%
Employer'S_Coalition_On_Health $241 - $338 316%
Alliance $247 324%
Hfn $250 - $338 328%
United_Healthcare $252 - $373 331%
Beloit_Health_System $255 335%
Aspirus_Health_Plan $256 336%
Cigna $263 345%
Health_Partners_Insurance $268 352%
Health_Payment_Systems $269 353%
UnitedHealthcare $275 361%
Dean_Health_Plan $281 369%
Medical_Associates $290 381%
Blue Cross Blue Shield $298 - $417 391%
Wps $304 - $335 399%
Employers_Healthcare_Coalition_Of_Wi $307 403%
Aetna $313 - $352 411%
Aspirus_Network_Inc $338 444%
Chorus_Community $351 461%
Ghc_Eau_Claire_Health_Plan $351 461%
Multiplan $351 - $404 461%
Sheybogan_Employers_Health_Network $351 461%
Coventry $373 490%
Dean_Care $373 490%
Healthsmart $386 507%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 600 Highland Avenue, Madison, WI 53792
  • CMS Rating: ★★★★★
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals