CMS Price Transparency Data

Speech therapy (group session)

Facility: Fairfield Medical Center

Billing Code: 92508 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 92508
Insurance Median: $71
Cash Discount Price: $46
vs. Medicare Baseline: 2.95x Medicare

The contracted insurance negotiated median rate for a Speech therapy (group session) at Fairfield Medical Center is $71. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $46. Compared to the federal Medicare reimbursement reference rate of $24.05, this hospital’s rate is 2.95x the Medicare baseline. Located in 401 North Ewing Street, Lancaster, OH.

Cash / Self-Pay

$46

Average discount available for prompt cash payment at this facility.

Insurance Median

$71

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: $46 (191%)

Insurance Median: $71 (295%)

Cash: $46 (191% of Medicare)

Ins. Median: $71 (295% 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 295% of the Medicare baseline (a markup of 195%). 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
Humana	$20 - $97	83%
Aetna	$23 - $67	96%
Blue Cross Blue Shield	$23 - $26,250	96%
Buckeye Community Health	$23 - $83	96%
Caresource	$23 - $80	96%
Medical Mutual	$23 - $33,500	96%
Medicare (plans)	$23	96%
Medigold	$23	96%
Molina	$23 - $79	96%
The Health Plan	$23 - $71	96%
UnitedHealthcare	$23 - $83	96%
Va Ccn	$23	96%
Valor Health Plan	$23	96%
Bwc	$32	133%
Oscar	$42	175%
Allied Benefit Systems	$71	295%
Meritain Health	$71	295%
Quality Care Partners/Ohio Ppo Connect	$73	304%
Medicaid / KanCare	$79	328%
The Ohio State Health Plan	$79	328%
Amerihealth Caritas Ohio	$83	345%
Cigna	$84	349%
Ohio Healthy	$96	399%
Multiplan	$97	403%
Miscellaneous Plans	$102	424%

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 $46.
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 Fairfield 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.