CMS Price Transparency Data
Speech therapy (group session)
Facility: Mercy Health Saint Mary's
Billing Code: 92508 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 92508
- Insurance Median: $61
- Cash Discount Price: $54
- vs. Medicare Baseline: 2.54x Medicare
The contracted insurance negotiated median rate for a Speech therapy (group session) at Mercy Health Saint Mary's is $61. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $54. Compared to the federal Medicare reimbursement reference rate of $24.05, this hospital’s rate is 2.54x the Medicare baseline. Located in 200 Jefferson Avenue Se, Grand Rapids, MI.
Cash / Self-Pay
$54
Average discount available for prompt cash payment at this facility.
Insurance Median
$61
Median negotiated contract rate across all mapped commercial carriers.
Medicare Reference Rate
$24.05
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Medicare Reference Baseline: $24.05 (100%)
Cash / Self-Pay: $54 (225%)
Insurance Median: $61 (254%)
Cash: $54 (225% of Medicare)
Ins. Median: $61 (254% of 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 254% of the Medicare baseline (a markup of 154%). 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.
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Access Health | $16 | 67% |
| Blue Cross Blue Shield | $20 - $40 | 83% |
| Medicaid / KanCare | $20 | 83% |
| Aetna | $23 - $52 | 96% |
| Align Senior Care | $23 | 96% |
| Blue Care Network Advantage | $23 | 96% |
| Correctional Recovery | $23 | 96% |
| Hospice Faith | $23 | 96% |
| Hospice Of Holland | $23 | 96% |
| Medicare (plans) | $23 | 96% |
| UnitedHealthcare | $24 - $83 | 100% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $26 | 108% |
| Molina Marketplace | $30 | 125% |
| Oscar | $30 | 125% |
| Vitalcore | $36 | 150% |
| Wellpath | $36 | 150% |
| Bcn Domestic | $40 | 166% |
| Blue Benefit Administrators Of Massachusetts | $40 | 166% |
| Blue Care Network | $40 | 166% |
| Blue Distinction Transplant | $40 | 166% |
| Blue Shield - Ca | $40 | 166% |
| Blue Shield - Id (Regence) | $40 | 166% |
| Blue Shield - Ny Highmark Northeastern | $40 | 166% |
| Blue Shield - Ny Highmark Western | $40 | 166% |
| Blue Shield - Pa (Highmark) | $40 | 166% |
| Blue Shield - Wa (Regence) | $40 | 166% |
| Health Choices | $40 - $63 | 166% |
| Kaiser Domestic | $40 | 166% |
| Wc Accident Fund | $45 | 187% |
| Wc Advantage | $45 | 187% |
| Wc Aig | $45 | 187% |
| Wc Allied | $45 | 187% |
| Wc Amerisure | $45 | 187% |
| Wc Amtrust | $45 | 187% |
| Wc Asu Risk Mgt | $45 | 187% |
| Wc Berkley Admin | $45 | 187% |
| Wc Broadspire | $45 | 187% |
| Wc Bunch & Associates | $45 | 187% |
| Wc Ccmsi | $45 | 187% |
| Wc Emc Insurance Company | $45 | 187% |
| Wc Esis | $45 | 187% |
| Wc Fcci | $45 | 187% |
| Wc Federated | $45 | 187% |
| Wc Gallagher Bassett | $45 | 187% |
| Wc Genex Care For Ohio | $45 | 187% |
| Wc Guard Insurance Company | $45 | 187% |
| Wc Hartford | $45 | 187% |
| Wc Liberty Mutual | $45 | 187% |
| Wc Meijers | $45 | 187% |
| Wc Michigan | $45 | 187% |
| Wc Mitchell Frankenmuth | $45 | 187% |
| Wc Pma | $45 | 187% |
| Wc Sedgwick | $45 | 187% |
| Wc Sentry | $45 | 187% |
| Wc Travelers | $45 | 187% |
| Wc Tristar | $45 | 187% |
| Wc Walmart | $45 | 187% |
| Wc Zurich | $45 | 187% |
| Nomi Health | $46 | 191% |
| Acs Benefit Services | $48 | 200% |
| Allied Benefit Systems | $48 | 200% |
| Claimchoice Adminstrators | $48 | 200% |
| Consociate | $48 | 200% |
| Cypress Benefit Administrators | $48 | 200% |
| Forest County Potawatomi | $48 | 200% |
| Health Smart | $48 | 200% |
| Healthgram | $48 | 200% |
| Healthscope | $48 | 200% |
| Secureone Preferred United Plans | $48 | 200% |
| Sisco Benefits | $48 | 200% |
| The Health Plan | $48 | 200% |
| Trustmark Small Business Benefits | $48 | 200% |
| Unified Group Services | $48 | 200% |
| Webtpa | $48 | 200% |
| Priority Health | $51 - $52 | 212% |
| U Of M Health Plan | $51 - $63 | 212% |
| Geha | $52 - $63 | 216% |
| Medical Mutual | $52 | 216% |
| Meritain | $52 | 216% |
| Preferred One | $52 | 216% |
| Asr Health Benefits | $53 | 220% |
| Hap | $53 - $64 | 220% |
| Caresource | $54 | 225% |
| Varipro | $54 | 225% |
| 1199 National Benefit Fund | $61 | 254% |
| Allied National Global Care | $61 | 254% |
| Asrm - Reliance Standard Life Insurance | $61 | 254% |
| Christian Care Ministry | $61 | 254% |
| Cigna | $61 | 254% |
| Dean Health | $61 | 254% |
| Fallon Health | $61 | 254% |
| Family Life Insurance Company | $61 | 254% |
| Ghc Scw | $61 | 254% |
| Group Pension Administrators | $61 | 254% |
| International Benefit Administrators | $61 | 254% |
| Lifetime Benefit Solutions | $61 | 254% |
| Manhattan Life | $61 | 254% |
| Medi Share | $61 | 254% |
| Multiplan | $61 | 254% |
| Mvp | $61 | 254% |
| Pai | $61 | 254% |
| Pan-American Life | $61 | 254% |
| Paramount Hmo | $61 | 254% |
| Phcs | $61 | 254% |
| Trinity Health Share | $61 | 254% |
| Acclaim | $63 | 262% |
| Administrative Concepts | $63 | 262% |
| Allegeant | $63 | 262% |
| Ameriben | $63 | 262% |
| American Family | $63 | 262% |
| American Healthcare Alliance | $63 | 262% |
| American Republic | $63 | 262% |
| Amerihealth | $63 | 262% |
| Aultcare | $63 | 262% |
| Automated Benefit Services | $63 | 262% |
| Auxiant | $63 | 262% |
| Benefit Administrative Systems,Llc | $63 | 262% |
| Boon Chapman | $63 | 262% |
| Cam Administrative Services | $63 | 262% |
| Christian Brother Services | $63 | 262% |
| Christian Brothers Holy Cross | $63 | 262% |
| Comprehensive Benefits | $63 | 262% |
| Continental Life Insurance | $63 | 262% |
| Custom Benefit Administrators | $63 | 262% |
| Employee Benefit Concepts | $63 | 262% |
| Employee Benefit Management | $63 | 262% |
| Enterprise Group Planning | $63 | 262% |
| Freedom Life Insurance Company | $63 | 262% |
| Group Administrators | $63 | 262% |
| Group Marketing Services | $63 | 262% |
| Guardian | $63 | 262% |
| Health America | $63 | 262% |
| Healthez | $63 | 262% |
| Humana | $63 - $83 | 262% |
| Insight | $63 | 262% |
| Intercare | $63 | 262% |
| Jfp Benefit Management | $63 | 262% |
| Jp Farley Corporation | $63 | 262% |
| Key Benefit Administrator | $63 | 262% |
| Liberty Union Life Assurance Co | $63 | 262% |
| Lucent Health | $63 | 262% |
| Luminare Health | $63 | 262% |
| Luminare Health (Detroit) | $63 | 262% |
| Medben | $63 | 262% |
| Medcost | $63 | 262% |
| Mutual Health Services | $63 | 262% |
| Mutual Of Omaha | $63 | 262% |
| Ncas | $63 | 262% |
| Nippon Life Ins | $63 | 262% |
| Nova | $63 | 262% |
| Painters Union Insurance Fund | $63 | 262% |
| Physicians Mutual | $63 | 262% |
| Plumbers Local 98 Insurance Fund | $63 | 262% |
| Prairie States | $63 | 262% |
| Primary Physician Care | $63 | 262% |
| Professional Benefit Administrators | $63 | 262% |
| The Loomis Company | $63 | 262% |
| Unicare | $63 | 262% |
| Us Health And Life | $63 | 262% |
| Valenz | $63 | 262% |
| Western & Southern Financial Group | $63 | 262% |
| Wps | $63 | 262% |
| Coventry | $66 | 274% |
| First Health | $66 | 274% |
| Cmh Allegan County | $83 | 345% |
| Cmh Ausable Valley | $83 | 345% |
| Cmh Barry County | $83 | 345% |
| Cmh Berrien County | $83 | 345% |
| Cmh Cass County | $83 | 345% |
| Cmh Clinton-Eaton-Ingham County | $83 | 345% |
| Cmh Kalamazoo | $83 | 345% |
| Cmh Kent County | $83 | 345% |
| Cmh Lenawee County | $83 | 345% |
| Cmh Misc | $83 | 345% |
| Cmh Monroe County | $83 | 345% |
| Cmh Montcalm County | $83 | 345% |
| Cmh Muskegon County | $83 | 345% |
| Cmh Newaygo County | $83 | 345% |
| Cmh North Country | $83 | 345% |
| Cmh Northern Lakes County | $83 | 345% |
| Cmh Ottawa County | $83 | 345% |
| Cmh Van Buren County | $83 | 345% |
| Cmh West Mi County | $83 | 345% |
| Magellan Behavioral Health | $83 | 345% |