CMS Price Transparency Data

Speech therapy (group session)

Facility: Adena Pike Medical Center

Billing Code: 92508 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 92508
Insurance Median: $146
Cash Discount Price: $97
vs. Medicare Baseline: 6.07x Medicare

The contracted insurance negotiated median rate for a Speech therapy (group session) at Adena Pike Medical Center is $146. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $97. Compared to the federal Medicare reimbursement reference rate of $24.05, this hospital’s rate is 6.07x the Medicare baseline. Located in 100 Dawn Lane, Waverly, OH.

Cash / Self-Pay

$97

Average discount available for prompt cash payment at this facility.

Insurance Median

$146

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: $97 (403%)

Insurance Median: $146 (607%)

Cash: $97 (403% of Medicare)

Ins. Median: $146 (607% 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 607% of the Medicare baseline (a markup of 507%). 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	$47 - $158	195%
Blue Cross Blue Shield	$47 - $168	195%
Buckeye Community Health Plan	$47	195%
Humana	$47 - $185	195%
Medical Mutual Of Ohio	$47 - $123	195%
Medigold	$47	195%
Molina	$47	195%
Care Source	$48	200%
Gateway Health	$64	266%
Molina Marketplace	$76	316%
Care Source Just4Me	$84	349%
Sidecar Health	$128	532%
Ohio Ppo Connect	$136	565%
The Health Plan	$136	565%
Cigna	$141	586%
Medical Mutual Of Ohio Supermed	$146	607%
First Health	$152	632%
Ohio Health Choice	$155	644%
UnitedHealthcare	$167	694%
Integrated Health Plan	$183	761%
Healthsmart	$185	769%
Multiplan/Private Healthcare Systems	$185	769%
Three Rivers Network	$185	769%

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 $97.
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 Adena Pike 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.