Speech therapy (language evaluation)
Facility: Salina Regional Health Center
Billing Code: 92507 (CPT)
- CPT Billing Code: 92507
- Insurance Median: $274
- Cash Discount Price: $238
- vs. Medicare Baseline: 3.60x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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 360% of the Medicare baseline (a markup of 260%). 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Preferred Phsic | $43 - $337 | 56% |
| Preferred Healthcare - All Other Plans | $58 - $454 | 76% |
| Aetna | $64 - $505 | 84% |
| Cigna | $64 - $505 | 84% |
| Providers Care (Wppa)-All Plans | $64 - $505 | 84% |
| Multiplan (Mpi)-All Plans | $64 - $505 | 84% |
| Blue Cross Blue Shield | $81 - $86 | 106% |
Consumer Guidance & Cost Commentary
For the speech therapy language evaluation service (CPT 92507) at Salina Regional Health Center in Salina, Kansas, the cash median price is $238.00, which is lower than the facility's negotiated rates of $274.00 and the median paid by insurers at $251.00. While the facility's cash rate is competitive, it is important to note that commercial insurance contracts often result in higher out-of-pocket costs for patients who have not yet met their deductibles, as the negotiated rates can exceed the cash price. The facility's negotiated rate of $274.00 is significantly higher than the Medicare benchmark of $76.15, reflecting the typical administrative markup and contract dynamics that inflate commercial pricing above the federal baseline.
Patients should be aware that balance billing is generally prohibited for emergency services and non-emergency care at in-network facilities under the No Surprises Act, though unexpected charges can still occur if ancillary services like emergency physicians or labs are out-of-network. To avoid surprise costs, consumers should request a full itemized bill before paying, as summary invoices may hide unbundled charges or services not rendered. Additionally, asking the hospital for a "prompt-pay" discount before scheduling can reduce the final cost, as facilities often offer 20% to 50% reductions for upfront cash payments to bypass costly insurance billing cycles.