CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: Princeton Community Hospital Assn Inc

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 92507
Insurance Median: $72
Cash Discount Price: $259
vs. Medicare Baseline: 0.95x Medicare

The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at Princeton Community Hospital Assn Inc is $72. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $259. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 0.95x the Medicare baseline. Located in 122 12Th Street, Princeton, WV.

Cash / Self-Pay

$259

Average discount available for prompt cash payment at this facility.

Insurance Median

$72

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: $259 (340%)

Insurance Median: $72 (95%)

Cash: $259 (340% of Medicare)

Ins. Median: $72 (95% 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.

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
Medicaid / KanCare	$22	29%
Pennsylvania Health & Wellness	$22	29%
Highmark Health Options West Va	$56	74%
Wellpoint West Virginia	$56	74%
Aetna	$57 - $76	75%
The Health Plan Wv	$57	75%
Blue Cross Blue Shield	$72 - $389	95%
Medicare (plans)	$72 - $76	95%
Humana	$76	100%
UnitedHealthcare	$79	104%

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 $259.
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 Princeton Community Hospital Assn Inc 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.