Speech therapy (language evaluation)
Facility: Wamego Health Center
Billing Code: 92507 (CPT)
- CPT Billing Code: 92507
- Insurance Median: $80
- Cash Discount Price: $159
- vs. Medicare Baseline: 1.05x 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.
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 |
|---|---|---|
| Medicaid / KanCare | $66 - $80 | 87% |
| UnitedHealthcare | $77 | 101% |
| Aetna | $80 | 105% |
| Providrs Care | $93 | 122% |
| Blue Cross Blue Shield | $102 - $108 | 134% |
Consumer Guidance & Cost Commentary
For the speech therapy language evaluation service (CPT 92507) at Wamego Health Center in Wamego, KS, the facility's cash median price of $159 is significantly higher than the state average, which is reflected in the Medicare benchmark of $76.15. While the facility offers a negotiated rate of $80 for commercial payers, this amount remains above the Medicare baseline, indicating a markup of 105% relative to the federal standard. Patients should be aware that while in-network insurance plans utilize a negotiated ceiling to protect members, these rates often exceed cash prices due to administrative overhead and contract dynamics. In cases where a patient has a high deductible or limited insurance coverage, paying the cash price directly may result in lower out-of-pocket costs compared to the insurance negotiated rate, provided the patient can afford the upfront payment.
To minimize unexpected costs, patients are encouraged to verify "self-pay" or "prompt-pay" discounts with the hospital before scheduling, as these programs can reduce the bill by 20% to 50% for upfront payment. It is important to avoid assuming that being in-network guarantees the lowest possible price, as different insurance carriers negotiate varying rates that may not align with the facility's cash pricing. Additionally, patients should request a detailed, itemized bill rather than accepting a summary invoice, as over 80% of medical bills contain errors such as unbundled codes or charges for services not rendered. By comparing the facility's rates directly to the Medicare benchmark and actively seeking prompt-pay incentives, consumers can make informed decisions that align with their financial situation and avoid unnecessary debt.