CMS Price Transparency Data

Speech therapy (group session)

Facility: Madison County Health Care System

Billing Code: 92508 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 92508
  • Insurance Median: $220
  • Cash Discount Price: $271
  • vs. Medicare Baseline: 9.15x Medicare
The contracted insurance negotiated median rate for a Speech therapy (group session) at Madison County Health Care System is $220. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $271. Compared to the federal Medicare reimbursement reference rate of $24.05, this hospital’s rate is 9.15x the Medicare baseline. Located in 300 West Hutchings Street, Winterset, IA.
Cash / Self-Pay
$271

Average discount available for prompt cash payment at this facility.

Insurance Median
$220

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: $271 (1127%)
Insurance Median: $220 (915%)
Cash: $271 (1127% of Medicare)
Ins. Median: $220 (915% 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 915% of the Medicare baseline (a markup of 815%). 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
Aetna $146 - $220 607%
Medical Associates Hp - All Plans $146 607%
Medigold-All Plans $146 607%
Tricare $146 607%
UnitedHealthcare $146 - $305 607%
American Hp Mcr Adv-All Plans $153 636%
Iowa Total Care Mcaid-All Plans $159 661%
Molina Mcaid/Chip -All Plans $165 686%
Amerigroup Mcaid-All Plans $169 703%
Madison County Sheriff-All Plans $170 707%
Blue Cross Blue Shield $192 - $211 798%
Oscar - All Plans $219 911%
Corvel Wc-All Plans $305 1268%
Choicecare-All Plans $322 1339%
First Choice-All Plans $322 1339%
First Health-All Plans $322 1339%
Integrated Hp-All Plans $322 1339%
Mutual Of Omaha-All Plans $322 1339%
Plaines Health-All Plans $322 1339%
Preferred Hlth Ntwork-All Plans $322 1339%
Principal Healthcare-All Plans $322 1339%
Usa Managed Care-All Plans $322 1339%
Medimore Employee Hp - All Plans $332 1380%
Midlands Choice - All Plans $332 1380%
Benefit Admin Of America-All Plans $339 1410%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 300 West Hutchings Street, Winterset, IA 50273
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals