CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: PAM Health Rehabiltation Hospital of Wausau

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 92507
Insurance Median: $180
Cash Discount Price: $360
vs. Medicare Baseline: 2.36x Medicare

The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at PAM Health Rehabiltation Hospital of Wausau is $180. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $360. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 2.36x the Medicare baseline. Located in 1111 Westwood Dr, Wausau, WI.

Cash / Self-Pay

$360

Average discount available for prompt cash payment at this facility.

Insurance Median

$180

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: $360 (473%)

Insurance Median: $180 (236%)

Cash: $360 (473% of Medicare)

Ins. Median: $180 (236% 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 236% of the Medicare baseline (a markup of 136%). 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
Network Health	$69 - $252	91%
Aetna	$73 - $288	96%
Blue Cross Blue Shield	$73 - $135	96%
Health Partners	$73 - $128	96%
Humana	$73	96%
Molina Healthcare Of Wisconsin	$73	96%
Security Health Plan	$73 - $100	96%
UnitedHealthcare	$73 - $120	96%
Velocity Provider Ppo Network	$88 - $270	116%
Cigna	$95	125%
Aspirus	$180	236%
Health Payment Services	$200	263%
The Alliance	$234	307%
Quik Trip	$270	355%
Usa Managed Care Organization	$270	355%
Multiplan	$288	378%

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 $360.
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 PAM Health Rehabiltation Hospital of Wausau 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.