Speech therapy (group session)
Facility: Rooks County Health Center
Billing Code: 92508 (CPT)
- CPT Billing Code: 92508
- Insurance Median: $56
- Cash Discount Price: $47
- vs. Medicare Baseline: 2.33x 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 233% of the Medicare baseline (a markup of 133%). 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 |
|---|---|---|
| Tricare | $29 | 121% |
| Celtic Mcr Adv | $29 | 121% |
| Veterans Admin - All Plans | $29 | 121% |
| Celtic Comm - All Other Plans | $32 | 133% |
| Blue Cross Blue Shield | $52 | 216% |
| UnitedHealthcare | $56 | 233% |
| Preferred Benefits Admin | $56 | 233% |
| Aetna | $56 | 233% |
| Health Partners - All Plans | $59 | 245% |
| Preferred Hlthcare - All Other Plans | $59 | 245% |
| Healthy Blue Mcaid - All Plans | $62 | 258% |
Consumer Guidance & Cost Commentary
For the speech therapy group session (CPT 92508) at Rooks County Health Center in Plainville, KS, the facility's cash price of $47.00 is lower than the median negotiated rate of $56.00 paid by most insurance plans, including UnitedHealthcare, Aetna, and Blue Cross Blue Shield. While the facility is a Critical Access Hospital owned by the Government Hospital District, the cash rate of $47.00 is notably higher than the state average for this service, which sits at $47.00. However, for patients with high-deductible plans who have not yet met their out-of-pocket maximum, paying the cash price directly could result in immediate savings compared to having insurance pay the higher negotiated rate of $56.00 and then facing a large deductible balance.
Patients should verify their specific plan details before scheduling, as the facility offers a cash price that may be more favorable than the commercial rates charged to insured members. It is important to note that while the No Surprises Act protects patients from balance billing for out-of-network providers at in-network facilities, this specific service is billed at a negotiated rate for most payers, meaning the patient will not face additional charges beyond their deductible and copay. To further reduce costs, patients should contact the billing department directly to inquire about any available self-pay or prompt-pay discounts, which can provide an additional fee reduction for upfront payment. Always request a full itemized bill before finalizing payment to ensure all charges are accurate and to identify any potential errors that could be disputed.