Speech therapy (group session)
Facility: Nmc Health
Billing Code: 92508 (CPT)
- CPT Billing Code: 92508
- Insurance Median: $74
- Cash Discount Price: $90
- vs. Medicare Baseline: 3.08x 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 308% of the Medicare baseline (a markup of 208%). 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 |
|---|---|---|
| Bluestem Pace | $23 | 96% |
| Aetna | $30 | 125% |
| Medicaid / KanCare | $36 | 150% |
| Leading Age | $36 | 150% |
| Blue Cross Blue Shield | $52 | 216% |
| Wppa | $70 | 291% |
| Occunet | $77 | 320% |
| Samaritan Ministries International | $83 | 345% |
| Medincrease Health Plan | $83 | 345% |
| Prime Health Services | $96 | 399% |
| UnitedHealthcare | $115 | 478% |
| Cigna | $122 | 507% |
Consumer Guidance & Cost Commentary
For the speech therapy group session (CPT 92508) at Nmc Health in Newton, Kansas, the cash median price is $90.00, which is notably lower than the facility's gross charge of $128.00. While the facility's negotiated rates with insurance payers range from $23 to $122, these amounts often exceed the cash price, meaning patients with high-deductible plans might save money by paying out-of-pocket or utilizing a prompt-pay discount. It is important to verify your specific plan's deductible status before scheduling, as paying the full negotiated rate without meeting your deductible can result in higher out-of-pocket costs than paying cash directly.
When evaluating the cost of this service, it is essential to compare rates against the Medicare benchmark rather than the hospital's gross chargemaster list. The Medicare amount for this procedure is $24.05, which serves as a scientifically validated baseline for the true cost of delivery. The facility's cash rate of $90.00 represents a significant markup over this benchmark, similar to how commercial negotiated rates often average 200% to 300% of Medicare. To ensure you are receiving fair pricing, we recommend requesting an itemized billing audit to confirm all charges are accurate and that no services were unbundled or double-billed, as over 80% of hospital bills contain errors that can be corrected through a formal written dispute.