CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: Charleston Area Medical Center

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 92507
Insurance Median: $363
Cash Discount Price: $415
vs. Medicare Baseline: 4.77x Medicare

The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at Charleston Area Medical Center is $363. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $415. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 4.77x the Medicare baseline. Located in 501 Morris Street, Charleston, WV.

Cash / Self-Pay

$415

Average discount available for prompt cash payment at this facility.

Insurance Median

$363

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: $415 (545%)

Insurance Median: $363 (477%)

Cash: $415 (545% of Medicare)

Ins. Median: $363 (477% 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 477% of the Medicare baseline (a markup of 377%). 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
Aetna	$59 - $422	77%
The Health Plan Of West Virginia Inc.	$59 - $418	77%
Unicare Health Plan Of West Virginia Inc.	$59	77%
Triwest Va	$70	92%
Blue Cross Blue Shield	$72 - $393	95%
Choicecare Network	$72 - $422	95%
UnitedHealthcare	$74 - $422	97%
West Virginia Senior Advantage Inc.	$76	100%
Optimum Choice Inc.	$79	104%
Integrated Medical Solutions	$140	184%
Naphcare	$144	189%
Caresource	$180	236%
Tricare	$239 - $259	314%
City Of Charleston	$298 - $323	391%
Cigna	$370 - $401	486%
Three Rivers Providers Network	$386 - $418	507%
Healthsmart	$390 - $422	512%
Multiplan	$390 - $422	512%

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 $415.
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 Charleston Area Medical Center 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.