CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: Childrens Hospital of Wisconsin

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 92507
  • Insurance Median: $338
  • Cash Discount Price: $295
  • vs. Medicare Baseline: 4.44x Medicare
The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at Childrens Hospital of Wisconsin is $338. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $295. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 4.44x the Medicare baseline. Located in 9000 W Wisconsin Ave, Milwaukee, WI.
Cash / Self-Pay
$295

Average discount available for prompt cash payment at this facility.

Insurance Median
$338

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: $295 (387%)
Insurance Median: $338 (444%)
Cash: $295 (387% of Medicare)
Ins. Median: $338 (444% 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 444% of the Medicare baseline (a markup of 344%). 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
My Choice Wisconsin $59 - $66 77%
UnitedHealthcare $59 - $533 77%
Chorus Community Health Plan $60 79%
Managed Health Services $64 84%
Molina Healthcare Of Wisconsin $66 87%
Blue Cross Blue Shield $68 - $665 89%
Icare $74 97%
Froedtert Health $261 - $595 343%
Medical College Of Wisconsin $261 - $490 343%
Network Health Plan $266 - $499 349%
Aspirus Health Plan $280 - $525 368%
Common Ground Healthcare Cooperative $280 - $595 368%
Trilogy Health Solutions $280 - $595 368%
Wps Health Plan $283 - $630 372%
Advocate Aurora Healthcare $287 - $539 377%
Centivo $291 - $546 382%
Health Partners $291 - $616 382%
Employer Health Care Alliance Cooperative $293 - $550 385%
Dean Health Plan $298 - $560 391%
Group Health Cooperative Of Eau Claire $298 - $560 391%
Oan Llc $298 - $560 391%
Security Health Plan $310 - $581 407%
Health Payment Systems $316 - $592 415%
Praire States $317 - $595 416%
Quartz Health Insurance $317 - $595 416%
Sheboygan Employer'S Health Network $317 - $595 416%
Mayo Clinic Health Solutions $325 - $609 427%
Aetna $328 - $623 431%
Bellin Thedacare $336 - $630 441%
Cigna $336 - $630 441%
Group Health Cooperative Of South Central Wisconsin $336 - $630 441%
Prevea Health Network $336 - $630 441%
Multiplan $339 - $665 445%
Coventry Health Care $354 - $665 465%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 9000 W Wisconsin Ave, Milwaukee, WI 53226
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Childrens