Speech therapy (group session)
Facility: Scott County Hospital
Billing Code: 92508 (CPT)
- CPT Billing Code: 92508
- Insurance Median: $92
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 3.83x 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 383% of the Medicare baseline (a markup of 283%). 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 |
|---|---|---|
| UnitedHealthcare | $11 - $97 | 46% |
| Humana | $43 | 179% |
| Blue Cross Blue Shield | $52 | 216% |
| Wppa | $61 - $1,200 | 254% |
| Aetna | $92 | 383% |
Consumer Guidance & Cost Commentary
For this speech therapy session at Scott County Hospital, the negotiated rates paid by insurance plans range from $11 to $1,200, with a median negotiated amount of $92. This figure is notably higher than the facility's cash median, which is not reported in this dataset. It is important to note that while commercial insurance contracts often set a ceiling on what payers will reimburse, these negotiated rates can sometimes exceed the actual cash price for self-pay patients. If you have a high-deductible plan where your deductible has not yet been met, paying the cash price directly could result in lower out-of-pocket costs compared to your insurance allowing a higher negotiated rate. To maximize savings, we recommend contacting the hospital directly to confirm their specific "self-pay" or "prompt-pay" discount programs, which can reduce the final bill by 20% to 50% if settled upfront.
The Medicare benchmark for this service is $24.05, which serves as a critical baseline for evaluating the facility's pricing markup. The facility's gross charge of $102.00 represents a significant increase over the Medicare rate, a common practice where commercial rates are marked up to cover administrative costs and profit margins. While the data does not provide a direct comparison to Kansas or Scott County state averages, the Medicare rate offers a scientifically validated cost baseline to understand the true value of the service. Patients should be aware that balance billing is generally prohibited for emergency care and non-emergency services at in-network facilities under the No Surprises Act, though unexpected charges can still occur if ancillary services like labs or emergency physicians are out-of-network. If you receive a bill that seems inconsistent with your insurance coverage, request a