CMS Price Transparency Data

Speech therapy (group session)

Facility: M Health Fairview St John's Hospital

Billing Code: 92508 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 92508
Insurance Median: $60
Cash Discount Price: $127
vs. Medicare Baseline: 2.49x Medicare

The contracted insurance negotiated median rate for a Speech therapy (group session) at M Health Fairview St John's Hospital is $60. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $127. Compared to the federal Medicare reimbursement reference rate of $24.05, this hospital’s rate is 2.49x the Medicare baseline. Located in 1575 Beam Avenue, Maplewood, MN.

Cash / Self-Pay

$127

Average discount available for prompt cash payment at this facility.

Insurance Median

$60

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: $127 (528%)

Insurance Median: $60 (249%)

Cash: $127 (528% of Medicare)

Ins. Median: $60 (249% 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 249% of the Medicare baseline (a markup of 149%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Itasca Medical Care	$18 - $23	75%
Medica	$18 - $112	75%
Primewest	$18 - $23	75%
South Country Health Alliance	$18 - $23	75%
Hennepin Health	$19 - $26	79%
Ucare	$19 - $65	79%
Blue Cross Blue Shield	$20 - $133	83%
Health Partners	$20 - $210	83%
Sanford Health Plan	$23 - $186	96%
Security Health Plan	$23 - $237	96%
UnitedHealthcare	$23 - $113	96%
Wellcare	$23	96%
America'S Ppo	$165 - $228	686%
First Health	$259	1077%
Multiplan	$269	1119%
Private Healthcare Systems	$269	1119%
Wisconsin Physician Services	$284	1181%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $127.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 92508.

Insurance In-Network Protection Plan

Contact your insurance company to confirm M Health Fairview St John's Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 92508.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.