CMS Price Transparency Data

Speech therapy (group session)

Facility: Atrium Health Pineville

Billing Code: 92508 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 92508
Insurance Median: $123
Cash Discount Price: $152
vs. Medicare Baseline: 5.11x Medicare

The contracted insurance negotiated median rate for a Speech therapy (group session) at Atrium Health Pineville is $123. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $152. Compared to the federal Medicare reimbursement reference rate of $24.05, this hospital’s rate is 5.11x the Medicare baseline. Located in 10628 Park Rd, Charlotte, NC.

Cash / Self-Pay

$152

Average discount available for prompt cash payment at this facility.

Insurance Median

$123

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: $152 (632%)

Insurance Median: $123 (511%)

Cash: $152 (632% of Medicare)

Ins. Median: $123 (511% 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 511% of the Medicare baseline (a markup of 411%). 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
Alliance	$11 - $32	46%
Amerihealth Caritas	$11 - $31	46%
Carolina Complete Health	$11 - $31	46%
Healthy Blue	$11 - $31	46%
Partners	$11 - $30	46%
Trillium	$11 - $32	46%
UnitedHealthcare	$11 - $143	46%
Vaya	$11 - $32	46%
Wellcare	$11 - $31	46%
Aetna	$23 - $252	96%
Cigna	$23 - $205	96%
Humana	$23	96%
Ortho Carolina	$28	116%
Ambetter / Centene	$88 - $110	366%
Blue Cross Blue Shield	$88 - $118	366%
Employers Health Network	$134	557%
Physician Reach Out	$152	632%
Medcost	$163 - $182	678%
Magellan	$182	757%
Gmmi	$197	819%
Quik Trip	$197	819%
Choicecare	$219 - $225	911%
Healthgram	$243	1010%
Provider Select	$246 - $273	1023%
Private Health Care Systems	$249	1035%
First Health	$252	1048%
Beechstreet	$273	1135%
Multiplan	$279	1160%

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 $152.
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 Atrium Health Pineville 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.