CMS Price Transparency Data

Speech therapy (group session)

Facility: Stephens County Hospital

Billing Code: 92508 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 92508
Insurance Median: $40
Cash Discount Price: $48
vs. Medicare Baseline: 1.66x Medicare

The contracted insurance negotiated median rate for a Speech therapy (group session) at Stephens County Hospital is $40. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $48. Compared to the federal Medicare reimbursement reference rate of $24.05, this hospital’s rate is 1.66x the Medicare baseline. Located in 163 Hospital Drive, Toccoa, GA.

Cash / Self-Pay

$48

Average discount available for prompt cash payment at this facility.

Insurance Median

$40

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$24.05

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $24.05 (100%)

Cash / Self-Pay: $48 (200%)

Insurance Median: $40 (166%)

Cash: $48 (200% of Medicare)

Ins. Median: $40 (166% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $24.05 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.

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
Amerigroup	$13 - $39	54%
Medicaid / KanCare	$13 - $40	54%
Blue Cross Blue Shield	$32 - $97	133%
Aetna	$34 - $103	141%
UnitedHealthcare	$35 - $107	146%
Cigna	$36 - $109	150%
Caresource	$40 - $122	166%
Medicare (plans)	$40 - $122	166%

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 $48.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 92508.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Stephens County Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 92508.
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.