CMS Price Transparency Data
Speech therapy (group session)
Facility: Mercy Hospital Carthage
Billing Code: 92508 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 92508
- Insurance Median: $71
- Cash Discount Price: $88
- vs. Medicare Baseline: 2.95x Medicare
The contracted insurance negotiated median rate for a Speech therapy (group session) at Mercy Hospital Carthage is $71. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $88. Compared to the federal Medicare reimbursement reference rate of $24.05, this hospital’s rate is 2.95x the Medicare baseline. Located in 3125 Dr Russell Smith Way, Carthage, MO.
Cash / Self-Pay
$88
Average discount available for prompt cash payment at this facility.
Insurance Median
$71
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: $88 (366%)
Insurance Median: $71 (295%)
Cash: $88 (366% of Medicare)
Ins. Median: $71 (295% 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 295% of the Medicare baseline (a markup of 195%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $11 - $185 | 46% |
| Medicaid / KanCare | $11 - $114 | 46% |
| Aetna | $17 - $184 | 71% |
| Cherokee Nation Health Serv Contracted [320066] | $17 - $57 | 71% |
| Cigna | $17 - $186 | 71% |
| Cross Timbers Hospice [20098] | $17 - $57 | 71% |
| Dept Of Veteran Affairs Contracted [320106] | $17 - $57 | 71% |
| Elara Caring Aspire Hospice [20433] | $17 - $57 | 71% |
| Globalhealth Contracted [320145] | $17 - $57 | 71% |
| Halo Hcr Inc Hospice Contracted [320432] | $17 - $57 | 71% |
| Halo Hcr Inc Hospice [20432] | $17 - $57 | 71% |
| Humana | $17 - $62 | 71% |
| Indian Health Service Contracted [320198] | $17 - $57 | 71% |
| Kindful Hospice Contracted [320434] | $17 - $57 | 71% |
| Kindful Hospice [20434] | $17 - $57 | 71% |
| Medical Associates Health Contracted [320444] | $17 - $57 | 71% |
| Medicare (plans) | $17 - $61 | 71% |
| Mercy Hospice Okc [20252] | $17 - $57 | 71% |
| Mercy Mgd Behavioral Health Contracted [320259] | $17 - $57 | 71% |
| Pace Of The Ozarks Contracted [320518] | $17 - $57 | 71% |
| Provider Partners Health Plans Contracted [320450] | $17 - $57 | 71% |
| Qual Choice Contracted [320325] | $17 - $57 | 71% |
| Tricare | $17 - $57 | 71% |
| UnitedHealthcare | $17 - $180 | 71% |
| Point C Contracted [320238] | $22 - $186 | 91% |
| Health Systems Inc Contracted [320174] | $27 - $89 | 112% |
| Insurance System Inc Contracted [320465] | $27 - $89 | 112% |
| Administrative Payor Contracted [320005] | $28 - $93 | 116% |
| Centivo Contracted [320505] | $29 - $95 | 121% |
| Healthscope Contracted [320182] | $33 - $108 | 137% |
| Ambetter / Centene | $35 - $114 | 146% |
| Home State Health Plan Contracted [320187] | $35 - $114 | 146% |
| Novasys Contracted [320285] | $35 - $114 | 146% |
| Benefit Management Contracted [320052] | $38 - $180 | 158% |
| Auxiant Contracted [320462] | $41 - $176 | 170% |
| Healthlink Contracted [320179] | $41 - $193 | 170% |
| Preferred Health Plan Contracted [320522] | $41 - $135 | 170% |
| Workers Comp [20426] | $50 - $207 | 208% |
| United Medical Resources Contracted [320454] | $52 - $186 | 216% |
| 90 Degree Benefits Contracted [320436] | $54 - $176 | 225% |
| Aither Health Contracted [320449] | $54 - $176 | 225% |
| Ebms Contracted [320493] | $54 - $176 | 225% |
| Edison Health Solutions Contracted [320502] | $54 - $176 | 225% |
| Imagine 360 Contracted [320494] | $54 - $176 | 225% |
| Mercy Benefit Admin Contracted [320251] | $54 - $186 | 225% |
| Reflect Health Contracted [320492] | $54 - $176 | 225% |
| Show-Me Health Administrators Contracted [320483] | $54 - $176 | 225% |
| Yuzu Health Contracted [320521] | $54 - $176 | 225% |
| Evolutions Health Care Contracted [320124] | $55 - $180 | 229% |
| First Health Contracted [320128] | $55 - $180 | 229% |
| Medica Contracted [320239] | $55 - $179 | 229% |
| Multiplan Contracted [320270] | $55 - $180 | 229% |
| Private Health Care Systems Contracted [320320] | $55 - $180 | 229% |
| American Healthcare Alliance Contracted [320020] | $57 - $186 | 237% |
| Ppo Plus Contracted [320310] | $57 - $186 | 237% |
| Usa Managed Care Org Contracted [320429] | $57 - $186 | 237% |