Speech therapy (group session)
Facility: William Newton Hospital
Billing Code: 92508 (CPT)
- CPT Billing Code: 92508
- Insurance Median: $14
- Cash Discount Price: $28
- vs. Medicare Baseline: 0.58x 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.
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 | $10 - $25 | 42% |
| Blue Cross Blue Shield | $10 - $49 | 42% |
| Triwest- All Plans | $10 | 42% |
| Ambetter / Centene | $10 - $28 | 42% |
| Providrs Care Nexus | $17 | 71% |
| Providrs Care - All Other Plans | $20 | 83% |
Consumer Guidance & Cost Commentary
For this speech therapy session at William Newton Hospital in Winfield, Kansas, the cash price is $28.00, which matches the facility's median paid amount. This rate is 60% of the Medicare benchmark of $24.05, indicating the facility's pricing is below the federal baseline. While the hospital is a Critical Access Hospital owned by the local government, patients should be aware that commercial insurance negotiated rates often exceed cash prices due to administrative overhead and contract structures. In this case, the median negotiated rate across payers is $14.00, which is lower than the cash price, suggesting that using insurance might result in a lower out-of-pocket cost if the patient's deductible has been met. However, for patients with high-deductible plans where the deductible has not yet been satisfied, paying the cash price directly could be more cost-effective than facing the full negotiated rate.
The facility reports a facility rating of 4 and serves six different insurance plans, with negotiated rates ranging from $10.00 to $28.00 depending on the carrier. Although specific county or state average comparisons are not provided in the current data, patients are encouraged to verify their specific plan's allowed amount before scheduling to ensure they are receiving the best possible rate. It is important to note that balance billing is generally prohibited for emergency services and non-emergency care at in-network facilities under federal law, though unexpected charges can still occur from out-of-network ancillary services like labs or emergency physicians. To avoid surprise costs, patients should request a self-pay classification and ask about prompt-pay discounts before check-in, as these upfront payment incentives can significantly reduce the final bill by bypassing costly claims processing fees.