Speech therapy (language evaluation)
Facility: Centura St. Catherine-Dodge City
Billing Code: 92507 (CPT)
- CPT Billing Code: 92507
- Insurance Median: $315
- Cash Discount Price: $192
- vs. Medicare Baseline: 4.14x 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 414% of the Medicare baseline (a markup of 314%). 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 |
|---|---|---|
| Centura Employee Plan | $72 | 95% |
| Kansas Health | $77 | 101% |
| Blue Cross Blue Shield | $77 - $91 | 101% |
| Humana | $77 | 101% |
| Aetna | $77 - $383 | 101% |
| Kaiser | $77 | 101% |
| Medicare (plans) | $77 | 101% |
| Cigna | $77 | 101% |
| UnitedHealthcare | $315 | 414% |
| Wpaa | $335 | 440% |
| Christian Health Aid | $383 | 503% |
| Multiplan | $383 - $431 | 503% |
| Health Partners Of Kansas | $431 | 566% |
Consumer Guidance & Cost Commentary
For CPT code 92507, speech therapy (language evaluation), the facility's cash median price is $192.00, which is significantly lower than the state average of $315.00 and the county average of $335.00. While many insurance plans negotiate rates ranging from $72 to $431, the cash price often represents the most affordable option for patients with high-deductible plans or those without coverage, as it bypasses administrative fees and insurance markup. To secure this lower rate, patients should explicitly request "self-pay" or "prompt-pay" discounts before scheduling, as hospitals frequently offer additional reductions for upfront payment that are not reflected in standard insurance allowed amounts.
When using insurance, patients must be aware that negotiated rates can vary widely, with some payers like Aetna showing a range up to $383 and others like Centura Employee Plan at $72. It is important to note that Medicare serves as a reliable benchmark for fair pricing, with the facility's rate of $76.15 representing the federal baseline; commercial rates are often 200% to 300% higher than this, though fair pricing is typically defined as 120% to 150% of Medicare. If a patient receives a bill exceeding their insurance allowed amount, they may be facing balance billing, which is generally prohibited for out-of-network services at in-network facilities under the No Surprises Act. Consumers should always demand a detailed, itemized bill to verify that all charges align with the negotiated rate and to identify any unbundled codes or services not rendered.