Speech therapy (group session)
Facility: Children'S Mercy South
Billing Code: 92508 (CPT)
- CPT Billing Code: 92508
- Insurance Median: $92
- Cash Discount Price: $68
- 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 - $95 | 46% |
| Healthy Blue | $12 - $64 | 50% |
| Medicaid / KanCare | $13 | 54% |
| Home State Health | $56 | 233% |
| Blue Cross Blue Shield | $58 - $104 | 241% |
| Cigna | $68 - $98 | 283% |
| Medica | $82 | 341% |
| Aetna | $85 - $96 | 353% |
| Nebraska Furniture Mart | $92 | 383% |
| Centivo | $92 | 383% |
| Health Midwest Comprehensive Care | $92 | 383% |
| Orscheln | $92 | 383% |
| Quiktrip | $92 | 383% |
| Wppa Providrs Care | $92 | 383% |
| Wellfit/Centrus | $92 | 383% |
| Humana | $94 | 391% |
| Coxhealth Network | $104 | 432% |
| Coventry Health Care Of Kansas | $104 | 432% |
| Mercy Health | $106 | 441% |
| Multiplan | $107 | 445% |
| American Healthcare Alliance | $120 | 499% |
| Healthlink | $124 | 516% |
| National Preferred Provider Network | $127 | 528% |
Consumer Guidance & Cost Commentary
For the speech therapy group session (CPT 92508) at Children's Mercy South in Overland Park, the facility's cash price of $68.00 is significantly lower than the state average of $92.00 and the Medicare benchmark of $24.05. While many commercial payers negotiate rates ranging from $11 to $127, the cash rate remains the most affordable option for patients without insurance. This pricing structure highlights a common billing dynamic where paying out-of-pocket can be more cost-effective than using insurance, particularly for those with high deductibles or those who wish to avoid administrative fees associated with claims processing. Patients should explicitly ask the billing department about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can further reduce the final amount owed.
Although the facility is a voluntary non-profit and in-network for many major carriers, the negotiated rates vary widely, with some plans paying as high as $127 while others pay as little as $11. It is important to note that the "median negotiated" rate of $92.00 represents the average across all payers, not necessarily the rate your specific plan will pay. Because insurance billing involves complex administrative structures that often inflate costs, the cash price of $68.00 serves as a reliable baseline for comparison. If you have insurance, you should verify your specific plan's allowed amount before treatment to ensure you are not facing balance billing or unexpected out-of-network charges, especially since federal protections like the No Surprises Act limit surprise bills for emergency services at in-network facilities.