Speech therapy (group session)
Facility: Memorial Hospital
Billing Code: 92508 (CPT)
- CPT Billing Code: 92508
- Insurance Median: $112
- Cash Discount Price: $204
- vs. Medicare Baseline: 4.66x 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 466% of the Medicare baseline (a markup of 366%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $54 | 225% |
| Humana | $102 | 424% |
| Tricare | $102 | 424% |
| Medicare (plans) | $103 | 428% |
| Ambetter / Centene | $112 | 466% |
| Coventry - All Other Plans | $184 | 765% |
| Health Partners Of Kansas - All Plans | $194 | 807% |
| Preferred Healthcare-All Plans | $194 | 807% |
| Wppa/Providers Care-All Plans | $286 | 1189% |
Consumer Guidance & Cost Commentary
For the speech therapy group session (CPT 92508) at Memorial Hospital in Abilene, KS, the cash price is $204.00, which matches the facility's median negotiated rate of $112.00 for most major payers like Blue Cross Blue Shield, Humana, and Tricare. While the facility's cash rate is significantly higher than the Medicare benchmark of $24.05, it is important to note that commercial negotiated rates often exceed cash prices due to administrative costs and contract structures. In this specific case, the cash price is actually the highest amount a patient might pay, as the median negotiated rates for in-network plans are lower than the cash charge. This highlights a scenario where paying out-of-pocket could be more expensive than using insurance, provided the patient's plan covers the service.
Patients should be aware that balance billing is generally prohibited for out-of-network services at in-network facilities under the No Surprises Act, though unexpected ancillary charges can still occur. If you choose to pay cash, you may be eligible for a prompt-pay discount by asking the hospital directly before scheduling, as these discounts are not automatically applied. Additionally, since over 80% of hospital bills contain errors, it is advisable to request a full itemized audit rather than accepting a summary bill, ensuring you are not charged for services not rendered or unbundled components. Always verify your deductible status and confirm self-pay or prompt-pay rates with the billing department to avoid unexpected costs.