Speech therapy (group session)
Facility: Pratt Regional Medical Center
Billing Code: 92508 (CPT)
- CPT Billing Code: 92508
- Insurance Median: $118
- Cash Discount Price: $99
- vs. Medicare Baseline: 4.91x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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 491% of the Medicare baseline (a markup of 391%). 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Celtic Insurance Company | $23 | 96% |
| Healthy Blue | $24 | 100% |
| UnitedHealthcare | $25 - $145 | 104% |
| Christian Health Aid | $107 | 445% |
| Health Partners Of Kansas | $121 | 503% |
| Aetna | $128 | 532% |
| Choicecare | $142 | 590% |
Consumer Guidance & Cost Commentary
For this speech therapy session at Pratt Regional Medical Center in Pratt, Kansas, the cash price is $99.00, which is notably lower than the facility's negotiated rates with major insurers like UnitedHealthcare (ranging from $25 to $145) and Aetna ($128). While the facility's cash rate is $142.00 gross, the actual cash-pay median is $99.00, making it a potentially more affordable option for patients with high-deductible plans or those without insurance, as the negotiated rates often exceed the cash price. It is important to note that commercial rates can sometimes be higher than cash prices due to administrative overhead and contract structures, so patients should verify if they qualify for self-pay or prompt-pay discounts before scheduling to ensure they are not paying more than necessary.
The facility's pricing is also contextualized by Medicare benchmarks, where the Medicare amount of $24.05 serves as the baseline for evaluating markup; commercial negotiated rates typically average between 200% and 300% of this figure, though fair pricing is often defined as 120% to 150%. For this specific code, the gross charge of $142.00 represents a significant markup over the Medicare rate, highlighting the importance of comparing rates against federal standards rather than the hospital's list price. Additionally, while the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, patients should still request an itemized bill to ensure no unbundled charges or services not rendered are included, as over 80% of hospital bills contain errors that can be resolved through a formal written