CMS Price Transparency Data

Speech therapy (group session)

Facility: Metropolitan Hospital Center

Billing Code: 92508 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 92508
Insurance Median: $148
Cash Discount Price: Unavailable
vs. Medicare Baseline: 6.15x Medicare

The contracted insurance negotiated median rate for a Speech therapy (group session) at Metropolitan Hospital Center is $148. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $24.05, this hospital’s rate is 6.15x the Medicare baseline. Located in 1901 First Avenue, New York, NY.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$148

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%)

Insurance Median: $148 (615%)

Ins. Median: $148 (615% 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 615% of the Medicare baseline (a markup of 515%). 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
Aetna	$16 - $257	67%
Healthfirst	$22 - $221	91%
Wellcare	$29	121%
Fidelis	$39 - $221	162%
Local 1199	$78	324%
Metroplus	$90 - $221	374%
Amidacare	$98	407%
Blue Cross Blue Shield	$98 - $239	407%
Carelon	$98 - $194	407%
Senior Whole Health	$98	407%
United	$98 - $504	407%
United Behavioral Health	$98 - $108	407%
Affinity	$100 - $221	416%
Carelon (Amida Care)	$100	416%
Vnsny	$100 - $254	416%
Emblem	$147 - $319	611%
Centerlight	$149	620%
Elderplan	$194	807%
Multiplan	$239	994%
Villagecare Max	$254	1056%
Magnacare	$320	1331%
Oxford	$362 - $410	1505%
Oscar	$614	2553%

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 $X.
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 Metropolitan Hospital 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.