CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: The Outer Banks Hospital, Inc

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 92507
Insurance Median: $395
Cash Discount Price: $347
vs. Medicare Baseline: 5.19x Medicare

The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at The Outer Banks Hospital, Inc is $395. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $347. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 5.19x the Medicare baseline. Located in 4800 South Croatan Highway, Nags Head, NC.

Cash / Self-Pay

$347

Average discount available for prompt cash payment at this facility.

Insurance Median

$395

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: $347 (456%)

Insurance Median: $395 (519%)

Cash: $347 (456% of Medicare)

Ins. Median: $395 (519% 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 519% of the Medicare baseline (a markup of 419%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Blue Cross Blue Shield	$192 - $380	252%
Carolina Complete Health [1317]	$202	265%
Wellcare [1320]	$203	267%
Amerihealth McAid Adv [1316]	$204	268%
Trillium [1296]	$223	293%
Liberty Advantage [1313]	$228	299%
UnitedHealthcare	$234 - $364	307%
Humana	$236	310%
Aetna	$241 - $485	316%
Longevity Health [1411]	$282	370%
Nc Dept of Public Safety [1095]	$391	513%
Medcost [1067]	$399 - $418	524%
Cigna	$527 - $589	692%
Multiplan [1031]	$589	773%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $347.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 92507.

Insurance In-Network Protection Plan

Contact your insurance company to confirm The Outer Banks Hospital, Inc is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 92507.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.