CMS Price Transparency Data

Speech therapy (group session)

Facility: Saint Michael's Medical Center

Billing Code: 92508 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 92508
Insurance Median: $59
Cash Discount Price: $26
vs. Medicare Baseline: 2.45x Medicare

The contracted insurance negotiated median rate for a Speech therapy (group session) at Saint Michael's Medical Center is $59. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $26. Compared to the federal Medicare reimbursement reference rate of $24.05, this hospital’s rate is 2.45x the Medicare baseline. Located in 111 Central Avenue, Newark, NJ.

Cash / Self-Pay

$26

Average discount available for prompt cash payment at this facility.

Insurance Median

$59

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: $26 (108%)

Insurance Median: $59 (245%)

Cash: $26 (108% of Medicare)

Ins. Median: $59 (245% 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 245% of the Medicare baseline (a markup of 145%). 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
Tricare	$21	87%
Aetna	$27 - $57	112%
Amerihealth	$27	112%
Horizon	$27 - $247	112%
Humana	$27	112%
Medicare (plans)	$27	112%
New Jersey Out of State	$27	112%
UnitedHealthcare	$27 - $499	112%
Wellpoint Amerigroup	$27	112%
Clover Health	$28	116%
Curana	$28	116%
Wellcare	$28 - $36	116%
Fairprice Healthcare Holdings - Fphh	$32	133%
Employer Direct Healthcare	$38	158%
Naphcare	$42	175%
Coventry	$54	225%
Cigna	$158	657%

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 $26.
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 Saint Michael's Medical Center 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.