CMS Price Transparency Data
Speech therapy (group session)
Facility: Mount Carmel East & West
Billing Code: 92508 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 92508
- Insurance Median: $56
- Cash Discount Price: $77
- vs. Medicare Baseline: 2.33x Medicare
The contracted insurance negotiated median rate for a Speech therapy (group session) at Mount Carmel East & West is $56. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $77. Compared to the federal Medicare reimbursement reference rate of $24.05, this hospital’s rate is 2.33x the Medicare baseline. Located in 6001 East Broad Street, Columbus, OH.
Cash / Self-Pay
$77
Average discount available for prompt cash payment at this facility.
Insurance Median
$56
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: $77 (320%)
Insurance Median: $56 (233%)
Cash: $77 (320% of Medicare)
Ins. Median: $56 (233% 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 233% of the Medicare baseline (a markup of 133%). 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.
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 |
|---|---|---|
| Medicare (plans) | $20 - $24 | 83% |
| Aetna | $23 - $119 | 96% |
| Blue Cross Blue Shield | $23 - $119 | 96% |
| UnitedHealthcare | $23 - $283 | 96% |
| The Health Plan | $24 - $78 | 100% |
| Blue Benefit Administrators Of Massachusetts | $30 | 125% |
| Blue Care Network | $30 | 125% |
| Blue Distinction Transplant | $30 | 125% |
| Blue Shield - Ca | $30 | 125% |
| Blue Shield - Id (Regence) | $30 | 125% |
| Blue Shield - Ny Highmark Northeastern | $30 | 125% |
| Blue Shield - Ny Highmark Western | $30 | 125% |
| Blue Shield - Pa (Highmark) | $30 | 125% |
| Blue Shield - Wa (Regence) | $30 | 125% |
| Hospice Mount Carmel | $38 | 158% |
| Oscar | $38 | 158% |
| Medical Mutual | $42 - $91 | 175% |
| Enterprise Group Planning | $45 | 187% |
| Custom Design Benefits | $48 | 200% |
| Quality Care Partners | $52 | 216% |
| Geha | $53 - $283 | 220% |
| Gravie Admin Services | $53 | 220% |
| Healthez | $53 | 220% |
| Meritain | $53 | 220% |
| Webtpa | $53 | 220% |
| Access Health | $56 | 233% |
| Acclaim | $56 | 233% |
| Administrative Concepts | $56 | 233% |
| Allegeant | $56 | 233% |
| Allied Benefit Systems | $56 | 233% |
| American Family | $56 | 233% |
| American Healthcare Alliance | $56 | 233% |
| American National | $56 | 233% |
| American Republic | $56 | 233% |
| Amerihealth | $56 | 233% |
| Aultcare | $56 | 233% |
| Automated Benefit Services | $56 | 233% |
| Auxiant | $56 | 233% |
| Benefit Administrative Systems,Llc | $56 | 233% |
| Boon Chapman | $56 | 233% |
| Cam Administrative Services | $56 | 233% |
| Christian Brother Services | $56 | 233% |
| Christian Brothers Holy Cross | $56 | 233% |
| Claimchoice Adminstrators | $56 | 233% |
| Comprehensive Benefits | $56 | 233% |
| Continental Life Insurance | $56 | 233% |
| Coventry | $56 | 233% |
| Custom Benefit Administrators | $56 | 233% |
| Cypress Benefit Administrators | $56 | 233% |
| Employee Benefit Concepts | $56 | 233% |
| Employee Benefit Management | $56 | 233% |
| Forest County Potawatomi | $56 | 233% |
| Freedom Life Insurance Company | $56 | 233% |
| Group Administrators | $56 | 233% |
| Group Marketing Services | $56 | 233% |
| Group Pension Administrators | $56 | 233% |
| Guardian | $56 | 233% |
| Health America | $56 | 233% |
| Health Choices | $56 | 233% |
| Healthcare Management Admin | $56 | 233% |
| Insight | $56 | 233% |
| Intercare | $56 | 233% |
| Jfp Benefit Management | $56 | 233% |
| Jp Farley Corporation | $56 | 233% |
| Key Benefit Administrator | $56 | 233% |
| Liberty Union Life Assurance Co | $56 | 233% |
| Lucent Health | $56 | 233% |
| Luminare Health | $56 | 233% |
| Magnacare | $56 | 233% |
| Medcost | $56 | 233% |
| Mutual Health Services | $56 | 233% |
| Mutual Of Omaha | $56 | 233% |
| Ncas | $56 | 233% |
| Nippon Life Ins | $56 | 233% |
| Nova | $56 | 233% |
| Painters Union Insurance Fund | $56 | 233% |
| Physicians Mutual | $56 | 233% |
| Plumbers Local 98 Insurance Fund | $56 | 233% |
| Prairie States | $56 | 233% |
| Preferred One | $56 | 233% |
| Primary Physician Care | $56 | 233% |
| Professional Benefit Administrators | $56 | 233% |
| Secureone Preferred United Plans | $56 | 233% |
| Siho Insurance Services | $56 | 233% |
| Sisco Benefits | $56 | 233% |
| The Loomis Company | $56 | 233% |
| Trustmark Small Business Benefits | $56 | 233% |
| U Of M Health Plan | $56 | 233% |
| Unicare | $56 | 233% |
| Unified Group Services | $56 | 233% |
| Us Health And Life | $56 | 233% |
| Valenz | $56 | 233% |
| Varipro | $56 | 233% |
| Wps | $56 | 233% |
| Western & Southern Financial Group | $58 | 241% |
| Humana | $61 - $119 | 254% |
| First Health | $63 | 262% |
| Medben | $71 - $89 | 295% |
| Consociate | $73 | 304% |
| Health Ohio Network | $73 | 304% |
| Caresource | $87 | 362% |
| Healthlink Inc | $89 | 370% |
| Medical Benefits Mutual | $89 | 370% |
| Ohio Health Choice | $89 | 370% |
| Ohio Ppo Connect | $89 | 370% |
| Ameriben | $95 | 395% |
| Luminare Health (Detroit) | $95 | 395% |
| Medi Share | $95 | 395% |
| Multiplan | $95 | 395% |
| Ohiohealthy | $95 | 395% |
| Osu Not Independent Choice | $95 | 395% |
| Phcs | $95 | 395% |
| Philadelphia American Life Insurance | $95 | 395% |
| Twin Valley Psychiatric | $95 | 395% |
| Rural Carrier Health Benefit Plan | $96 | 399% |
| Health Smart | $101 | 420% |
| Bccp | $119 | 495% |
| Medicaid / KanCare | $119 | 495% |
| Optima Health | $119 | 495% |
| American Postal Workers Secondary | $232 | 965% |
| Cigna | $232 | 965% |
| Health Partners | $232 | 965% |
| Healthgram | $232 | 965% |
| Mvp | $232 | 965% |
| Priority Health | $232 | 965% |
| Crime Victim Assistance | $632 | 2628% |
| Ohio Safe Program | $632 | 2628% |