CMS Price Transparency Data

Speech therapy (group session)

Facility: Franciscan Health Michigan City

Billing Code: 92508 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 92508
Insurance Median: $260
Cash Discount Price: $123
vs. Medicare Baseline: 10.81x Medicare

The contracted insurance negotiated median rate for a Speech therapy (group session) at Franciscan Health Michigan City is $260. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $123. Compared to the federal Medicare reimbursement reference rate of $24.05, this hospital’s rate is 10.81x the Medicare baseline. Located in 3500 Franciscan Way, Michigan City, IN.

Cash / Self-Pay

$123

Average discount available for prompt cash payment at this facility.

Insurance Median

$260

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: $123 (511%)

Insurance Median: $260 (1081%)

Cash: $123 (511% of Medicare)

Ins. Median: $260 (1081% 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 1081% of the Medicare baseline (a markup of 981%). 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
Research/Grant [2012]	$5	21%
Medicare (plans)	$23	96%
Aetna	$45	187%
Blue Cross Blue Shield	$45 - $296	187%
Managed Care [2000]	$45 - $534	187%
Unicare [1150]	$45 - $46	187%
Workers Comp [1172]	$46	191%
Mdwise [1175]	$186	773%
Medicaid / KanCare	$186 - $224	773%
Managed Health Services [1302]	$192	798%
Commercial [2001]	$237 - $593	985%
United Medical Resources [1158]	$237	985%
United Medical Resources [1301]	$237 - $260	985%
UnitedHealthcare	$237 - $260	985%
Cigna	$253 - $415	1052%
Great West Insurance [1055]	$358	1489%

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 $123.
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 Franciscan Health Michigan City 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.