CMS Price Transparency Data
Speech therapy (language evaluation)
Facility: Watsonville Community Hospital
Billing Code: 92507 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 92507
- Insurance Median: $961
- Cash Discount Price: $961
- vs. Medicare Baseline: 12.62x Medicare
The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at Watsonville Community Hospital is $961. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $961. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 12.62x the Medicare baseline. Located in 75 Nielson Street, Watsonville, CA.
Cash / Self-Pay
$961
Average discount available for prompt cash payment at this facility.
Insurance Median
$961
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: $961 (1262%)
Insurance Median: $961 (1262%)
Cash: $961 (1262% of Medicare)
Ins. Median: $961 (1262% 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 1262% of the Medicare baseline (a markup of 1162%). 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.
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Medi-Cal E.R. | $38 | 50% |
| Healthy Families | $38 | 50% |
| Well Path | $38 - $1,602 | 50% |
| Medi-Cal/Eds | $38 | 50% |
| Ccs/Monterey County | $38 | 50% |
| California Childrens Srvs | $38 | 50% |
| Medicaid / KanCare | $38 | 50% |
| Alliance/Sccho | $73 - $74 | 96% |
| Ace-Usa | $82 | 108% |
| Pinnacle Healthcare Uc | $82 | 108% |
| Veterans Administration | $82 | 108% |
| Tricare | $82 | 108% |
| Hartford Workers' Comp | $82 | 108% |
| Keenan & Assoc Work Comp | $82 | 108% |
| U.S. Dept. of Labor | $82 | 108% |
| Miscellaneous Work Comp | $82 | 108% |
| Workers Comp | $82 | 108% |
| Beta Healthcare Group | $82 | 108% |
| Crawford & Co | $82 | 108% |
| Gallagher Bassett Svcs | $82 | 108% |
| Republic Idemnity W/Comp | $82 | 108% |
| Kemper Group Workers Comp | $82 | 108% |
| Medicare (plans) | $82 - $84 | 108% |
| Fleming & Associates | $82 | 108% |
| Western Growers Work Comp | $82 | 108% |
| Fireman's Fund Work Comp | $82 | 108% |
| Travelers Insurance | $82 - $1,602 | 108% |
| Blue Shield PPO | $82 | 108% |
| Liberty Mutual Work Comp | $82 | 108% |
| Health Net of California | $84 - $1,004 | 110% |
| UnitedHealthcare | $84 - $961 | 110% |
| Alignment Health Plan | $84 | 110% |
| Secure Horizons Dign HMO | $84 - $320 | 110% |
| Secure Horizons | $84 | 110% |
| Kaiser Northern | $266 | 349% |
| Victim Compensation Plan | $288 - $1,602 | 378% |
| Medicruz | $288 | 378% |
| Blue Cross Blue Shield | $320 - $1,427 | 420% |
| Pacificare HMO | $320 - $961 | 420% |
| Cigna | $320 - $1,121 | 420% |
| Great-West/Phcs | $320 - $1,121 | 420% |
| Blue Shield HMO | $320 | 420% |
| Health Net Pmg HMO | $320 - $1,004 | 420% |
| Aetna | $320 - $1,314 | 420% |
| Western Growers Trust/Bc | $641 - $1,427 | 842% |
| Pinnacle Claims Tpa/Bc | $641 - $1,427 | 842% |
| Western Health Advantage | $801 | 1052% |
| Pacificare PPO | $961 | 1262% |
| Health Net Smartcare Netw | $961 | 1262% |
| Self Pay | $961 | 1262% |
| Health Net Blue and Gold | $1,004 | 1318% |
| Health Net Canopycare HMO | $1,004 | 1318% |
| Adventist Risk Management | $1,121 - $1,281 | 1472% |
| Transwestern | $1,121 - $1,281 | 1472% |
| Geha (Ccn) | $1,121 - $1,281 | 1472% |
| First Health | $1,121 - $1,281 | 1472% |
| Private Healthcare System | $1,249 | 1640% |
| Multiplan Inc PPO | $1,249 | 1640% |
| Coastal Healthcare Admin | $1,362 - $1,442 | 1789% |
| Salinas Valley Mem Hops | $1,362 | 1789% |
| Sheet Metal Workers | $1,389 - $1,427 | 1824% |
| State Compensation Fund | $1,389 - $1,427 | 1824% |
| Carpenters H&W Trust | $1,389 - $1,427 | 1824% |
| Teamsters Benefit Trust | $1,389 - $1,427 | 1824% |
| Operating Engineers | $1,389 - $1,427 | 1824% |
| Delta Health Systems | $1,389 - $1,427 | 1824% |
| Calif Ironworkers Field | $1,389 - $1,427 | 1824% |
| Claims Management Wc | $1,389 - $1,427 | 1824% |
| Laborers Health & Welfare | $1,389 - $1,427 | 1824% |
| Monterey Bay Pub Emp Trst | $1,389 - $1,427 | 1824% |
| Robert Kennedy/Ccn | $1,389 - $1,427 | 1824% |
| City of Wats/Pinnacle Clm | $1,389 - $1,427 | 1824% |
| United Administrative | $1,602 | 2104% |
| Farmers Insurance | $1,602 | 2104% |
| Sutter Health Plus | $1,602 | 2104% |
| Humana | $1,602 | 2104% |
| Miscellaneous Auto | $1,602 | 2104% |
| Wholesale Beer Distributo | $1,602 | 2104% |
| Apwu Health Plan | $1,602 | 2104% |
| North Calif Bakery Driver | $1,602 | 2104% |
| Zenith National Ins | $1,602 | 2104% |
| Aaa | $1,602 | 2104% |
| Miscellaneous Insurance | $1,602 | 2104% |
| Prucare Pmg POS | $1,602 | 2104% |
| Aarp | $1,602 | 2104% |
| Prucare Pmg HMO | $1,602 | 2104% |
| Physicians Mutual | $1,602 | 2104% |
| State Farm Ins | $1,602 | 2104% |
| Bankers Life & Casualty | $1,602 | 2104% |
| Allstate | $1,602 | 2104% |