92523

Evaluation of speech sound production with evaluation of language comprehension and expression

Medicare pricing data for 3,705 providers across 52 states

🤖AI Overview

Note: These costs reflect the Medicare physician/supplier component. Hospital facility fees are billed separately and can be 2-5x the physician fee.

💡 What You Should Know

Evaluation of speech sound production with evaluation of language comprehension and expression (HCPCS code 92523) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $224.79, but hospitals typically charge $352.06 — a 1.6x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$44.96

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $224.79, your out-of-pocket cost would be approximately $44.96. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$224.79
Average Hospital Charge
$352.06
Markup Ratio
1.6x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$352.06
Medicare Allowed$224.79
Medicare Payment$175.14

Hospitals charge 1.6x more than what Medicare allows for this procedure. Medicare actually pays $175.14 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$265$5531293+17.8%
New Jersey$242$3241942,850+7.9%
New York$241$3633043,977+7.1%
District of Columbia$240$3071066+6.8%
Connecticut$239$32721219+6.4%
Hawaii$237$34912133+5.3%
Rhode Island$235$3261083+4.5%
Massachusetts$234$32841393+4.0%
California$234$4191881,147+3.9%
Washington$232$40351454+3.3%
Delaware$232$32716341+3.0%
Maryland$231$31884953+2.9%
New Hampshire$230$313981+2.3%
Pennsylvania$230$3311512,326+2.3%
Virginia$227$3341121,304+1.0%
Montana$226$3671984+0.6%
Oregon$226$36026111+0.3%
North Dakota$226$36523149+0.3%
Maine$225$33417218+0.3%
Wyoming$225$26613131+0.3%
New Mexico$225$3331557-0.1%
Minnesota$224$46968558-0.4%
South Dakota$224$375767-0.5%
Texas$223$3362291,779-0.8%
Illinois$222$3611641,940-1.1%
Colorado$221$327100742-1.5%
Georgia$221$3351081,015-1.9%
Puerto Rico$219$242722-2.4%
Wisconsin$218$36076804-2.9%
Louisiana$218$29345269-2.9%
Missouri$218$395801,068-3.0%
Michigan$218$347101609-3.2%
Florida$217$3302993,360-3.3%
Ohio$217$3221151,215-3.4%
Arizona$216$34754386-3.8%
South Carolina$216$313831,278-3.9%
Utah$216$42731121-4.1%
Tennessee$215$33893989-4.5%
Alabama$215$31437316-4.6%
Kansas$214$35356589-4.6%
Indiana$214$350100933-4.6%
North Carolina$214$324111774-4.8%
Nevada$214$85337563-4.8%
West Virginia$214$28829232-4.8%
Iowa$212$35744320-5.5%
Kentucky$212$34278734-5.5%
Oklahoma$212$31844284-5.6%
Vermont$212$231416-5.8%
Nebraska$211$35264421-6.3%
Idaho$210$2792562-6.4%
Mississippi$210$28939375-6.4%
Arkansas$210$35042466-6.5%

⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.

Related from TheDataProject.ai

💊 Need post-procedure medications? Check costs on OpenPrescriber