Speech therapy (language evaluation)
Facility: Lindsborg Community Hospital
Billing Code: 92507 (CPT)
- CPT Billing Code: 92507
- Insurance Median: $258
- Cash Discount Price: $238
- vs. Medicare Baseline: 3.39x 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 339% of the Medicare baseline (a markup of 239%). 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 |
|---|---|---|
| Tricare | $33 - $264 | 43% |
| Coventry Mcr Adv | $34 - $266 | 45% |
| Cigna | $60 - $477 | 79% |
| Coventry Comm-All Other Plans | $64 - $505 | 84% |
| UnitedHealthcare | $64 - $505 | 84% |
| Phcs Preferred-All Plans | $66 - $522 | 87% |
| Multiplan-All Plans | $66 - $522 | 87% |
| Century Health-All Plans | $67 - $533 | 88% |
| Health Partners -All Plans | $67 - $533 | 88% |
| Wppa-All Plans | $67 - $533 | 88% |
| Coventry Wc | $67 - $533 | 88% |
| Blue Cross Blue Shield | $77 | 101% |
Consumer Guidance & Cost Commentary
For the speech therapy language evaluation (CPT 92507) at Lindsborg Community Hospital, the cash median price is $238.00, which is lower than the facility's negotiated rates of $258.00 and the median paid by insurers at $261.00. While the facility is a Critical Access Hospital in Lindsborg, KS, the data does not provide specific county or state average figures for this procedure to make a direct comparison. However, patients with high-deductible plans may find the cash price more advantageous if their insurance negotiated rate exceeds $238.00, as paying upfront can bypass the administrative overhead and potential balance billing associated with insurance claims. It is important to note that commercial payers like Cigna and UnitedHealthcare have negotiated rates ranging from $60 to $505, significantly higher than the cash price, highlighting the potential savings of self-pay options.
To maximize savings, patients should explicitly request "self-pay" or "prompt-pay" discounts before scheduling, as these facilities often offer fee reductions of 20% to 50% for upfront payment. This discount mechanism allows hospitals to avoid costly claims processing and bad debt collection fees, making immediate payment a financially efficient choice for consumers. Additionally, because the No Surprises Act prohibits balance billing for out-of-network services at in-network facilities, patients can be confident that the negotiated rates listed represent the maximum allowed amount rather than a surprise bill. If you receive an itemized bill, ensure it is fully detailed to verify that no unbundled codes or services not rendered have inflated the total, as over 80% of hospital bills contain errors that can be