CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: Samuel Mahelona Memorial Hospital

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 92507
  • Insurance Median: $210
  • Cash Discount Price: $267
  • vs. Medicare Baseline: 2.76x Medicare
The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at Samuel Mahelona Memorial Hospital is $210. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $267. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 2.76x the Medicare baseline. Located in 4800 Kawaihau Road, Kapaa, HI.
Cash / Self-Pay
$267

Average discount available for prompt cash payment at this facility.

Insurance Median
$210

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: $267 (351%)
Insurance Median: $210 (276%)
Cash: $267 (351% of Medicare)
Ins. Median: $210 (276% 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 276% of the Medicare baseline (a markup of 176%). 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.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
UnitedHealthcare $21 - $206 28%
Humana $206 271%
Hawaii Medical Service Association $206 271%
Alohacare $206 271%
Kaiser Permanente $206 - $370 271%
Ohana Health Plan $206 271%
Devoted Health $226 297%
University Health Alliance $230 302%
Health Management Network $349 458%
Hawaii Western Management Group $390 512%
Mdx Hawaii $399 524%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 4800 Kawaihau Road, Kapaa, HI 96746
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - State
  • Hospital Type: Critical Access Hospitals