CMS Price Transparency Data

Speech therapy (group session)

Facility: Pocahontas Community Hospital

Billing Code: 92508 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 92508
Insurance Median: $142
Cash Discount Price: $149
vs. Medicare Baseline: 5.90x Medicare

The contracted insurance negotiated median rate for a Speech therapy (group session) at Pocahontas Community Hospital is $142. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $149. Compared to the federal Medicare reimbursement reference rate of $24.05, this hospital’s rate is 5.90x the Medicare baseline. Located in 606 N W 7Th Street, Pocahontas, IA.

Cash / Self-Pay

$149

Average discount available for prompt cash payment at this facility.

Insurance Median

$142

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: $149 (620%)

Insurance Median: $142 (590%)

Cash: $149 (620% of Medicare)

Ins. Median: $142 (590% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 590% of the Medicare baseline (a markup of 490%). 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
Molina	$74 - $149	308%
Wellpoint	$80 - $149	333%
Iowa Total Care	$83 - $149	345%
Aetna	$89 - $149	370%
Blue Cross Blue Shield	$95 - $149	395%
Health Partners	$141 - $142	586%
Humana	$142 - $149	590%
UnitedHealthcare	$143	595%
Cigna	$145	603%
Great West	$145	603%

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 $149.
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 Pocahontas Community 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.