CMS Price Transparency Data

Speech therapy (language evaluation)

Facility: Margaretville Memorial Hospital

Billing Code: 92507 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 92507
  • Insurance Median: $269
  • Cash Discount Price: $572
  • vs. Medicare Baseline: 3.53x Medicare
The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at Margaretville Memorial Hospital is $269. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $572. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 3.53x the Medicare baseline. Located in 42084 State Highway 28, Margaretville, NY.
Cash / Self-Pay
$572

Average discount available for prompt cash payment at this facility.

Insurance Median
$269

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: $572 (751%)
Insurance Median: $269 (353%)
Cash: $572 (751% of Medicare)
Ins. Median: $269 (353% 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 353% of the Medicare baseline (a markup of 253%). 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 $139 - $437 183%
Oxford $147 - $165 193%
Emblem Select Care (Exchange) $154 - $389 202%
Emblem Ghi/Hip Ppo/Cbp $156 - $412 205%
Oxford Exchange $158 - $393 207%
Emblem Ghi/Hip Hmo/Epo/Pos $181 - $458 238%
Aetna $189 - $252 248%
Mvp Exchange $238 - $372 313%
Blue Cross Blue Shield $252 - $530 331%
Mvp Gold (McR) $252 331%
Medicare (plans) $252 - $378 331%
Hamaspik (McR) $252 331%
Emblem $261 - $369 343%
Affinity By Molina McR $264 347%
Cdphp $277 364%
Mvp Hmo/Ppo $280 - $376 368%
Mvp $318 418%
Magnacare $390 512%
Magnacare Standard $400 525%
Magnacare Preferred $413 - $458 542%
Todays Options $415 545%
Self-Pay $438 - $572 575%
Multiplan $469 616%
First Health $515 676%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 42084 State Highway 28, Margaretville, NY 12455
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals