CMS Price Transparency Data

Speech therapy (group session)

Facility: Essentia Health St Mary's Medical Center

Billing Code: 92508 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 92508
  • Insurance Median: $55
  • Cash Discount Price: $80
  • vs. Medicare Baseline: 2.29x Medicare
The contracted insurance negotiated median rate for a Speech therapy (group session) at Essentia Health St Mary's Medical Center is $55. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $80. Compared to the federal Medicare reimbursement reference rate of $24.05, this hospital’s rate is 2.29x the Medicare baseline. Located in 402 East Second Street, Duluth, MN.
Cash / Self-Pay
$80

Average discount available for prompt cash payment at this facility.

Insurance Median
$55

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: $80 (333%)
Insurance Median: $55 (229%)
Cash: $80 (333% of Medicare)
Ins. Median: $55 (229% 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 229% of the Medicare baseline (a markup of 129%). 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.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Advocare/Security Health $24 100%
Blue Cross Blue Shield $24 - $92 100%
Freedom Blue Ppo $24 100%
Healthpartners Care Msho / Mcr Adv $24 100%
Imcare Msho (Ref Req) $24 100%
Imcare Msho Pcc Prime $24 100%
Imcare Msho Ref Req $24 100%
Itasca Med Care $24 100%
Medica Advantage Solutions $24 100%
Medica Msho/Dual Solutions $24 100%
Medica Prime Solution Group $24 100%
Medicare (plans) $24 100%
Nd Va Administration $24 100%
Platinum Blue / Vantage Blue $24 100%
Primewest $24 100%
Primewest Msho $24 100%
Secure Blue Msho $24 100%
Ubh Cost Plan $24 100%
Ubh Msho $24 100%
Ucare Msho $24 100%
UnitedHealthcare $24 - $89 100%
Medica Access $40 166%
Sanford Health Plan $47 - $55 195%
Healthpartners Care Pmap $48 200%
Blue Plus Pmap Pcc Prime $53 - $60 220%
Medica $67 - $69 279%
Medica Uplan $67 279%
Healthpartners $72 - $87 299%
Medica Choice $74 308%
Ucare $80 333%
Cigna $87 362%
Healthpartners Pcc Prime $87 362%
Wea $87 - $93 362%
Security Health $93 387%
America'S Ppo $94 391%
Wps $100 - $102 416%
Aetna $103 428%
Healthscope Benefits $103 428%
Healtheos $104 432%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 402 East Second Street, Duluth, MN 55805
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals