CMS Price Transparency Data

Speech therapy (group session)

Facility: Elizabethtown Community Hospital

Billing Code: 92508 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 92508
Insurance Median: $117
Cash Discount Price: $199
vs. Medicare Baseline: 4.86x Medicare

The contracted insurance negotiated median rate for a Speech therapy (group session) at Elizabethtown Community Hospital is $117. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $199. Compared to the federal Medicare reimbursement reference rate of $24.05, this hospital’s rate is 4.86x the Medicare baseline. Located in 75 Park Street, Elizabethtown, NY.

Cash / Self-Pay

$199

Average discount available for prompt cash payment at this facility.

Insurance Median

$117

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: $199 (827%)

Insurance Median: $117 (486%)

Cash: $199 (827% of Medicare)

Ins. Median: $117 (486% 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 486% of the Medicare baseline (a markup of 386%). 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
Capital District Physicians' Health Plan	$16 - $164	67%
Aetna	$76 - $149	316%
Blue Cross Blue Shield	$76 - $150	316%
Choicecare	$76 - $159	316%
Fidelis Care	$76	316%
Martins Point	$76	316%
Mvp	$76 - $155	316%
UnitedHealthcare	$76 - $183	316%
Veterans Affairs Community Care Network	$76	316%
Wellpath	$113	470%
Emblem Health	$159	661%
Harvard Pilgrim	$159	661%
Magnacare	$159	661%
Highmark Blueshield	$162	674%
Coventry	$169	703%
Multiplan	$179	744%

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 $199.
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 Elizabethtown Community 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.