Speech therapy (group session)
Facility: Cloud County Health Center
Billing Code: 92508 (CPT)
- CPT Billing Code: 92508
- Insurance Median: $194
- Cash Discount Price: $143
- vs. Medicare Baseline: 8.07x 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 807% of the Medicare baseline (a markup of 707%). 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 |
|---|---|---|
| Aetna | $184 - $190 | 765% |
| Pponext-All Plans | $194 | 807% |
| Mpi-All Plans | $194 | 807% |
| Health Partners - All Plans | $194 | 807% |
Consumer Guidance & Cost Commentary
For this speech therapy session at Cloud County Health Center in Concordia, KS, the facility's cash median rate of $143.00 is notably lower than the negotiated rates paid by major insurers like Aetna, Pponext-All Plans, Mpi-All Plans, and Health Partners - All Plans, which all average $194.00. While commercial insurance contracts often result in higher allowed amounts due to administrative overhead and network tiering, patients with high-deductible plans may find paying the cash price directly more cost-effective if their insurance deductible has not yet been met. It is important to note that the facility, a Critical Access Hospital, does not offer a specific self-pay or prompt-pay discount in this dataset, so patients should verify current financial assistance policies directly with the hospital before scheduling to ensure they are not inadvertently agreeing to higher billing structures.
When evaluating the cost of this service, it is essential to compare rates against the Medicare benchmark rather than the facility's gross charge of $204.00. The Medicare amount for this procedure is $24.05, and the commercial negotiated rate of $194.00 represents a significant markup relative to this federal baseline. This comparison highlights that commercial rates often exceed fair pricing standards, which are typically defined as 120% to 150% of the Medicare rate. Additionally, under federal protections such as the No Surprises Act, patients should be aware that balance billing for out-of-network services at in-network facilities is generally prohibited, and they should never sign away their rights to dispute unexpected charges without first requesting a formal, itemized audit of the bill.