CMS Price Transparency Data

Speech therapy (group session)

Facility: Wellspan Ephrata Community Hospital

Billing Code: 92508 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 92508
Insurance Median: $104
Cash Discount Price: $326
vs. Medicare Baseline: 4.32x Medicare

The contracted insurance negotiated median rate for a Speech therapy (group session) at Wellspan Ephrata Community Hospital is $104. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $326. Compared to the federal Medicare reimbursement reference rate of $24.05, this hospital’s rate is 4.32x the Medicare baseline. Located in 169 Martin Avenue, Ephrata, PA.

Cash / Self-Pay

$326

Average discount available for prompt cash payment at this facility.

Insurance Median

$104

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: $326 (1356%)

Insurance Median: $104 (432%)

Cash: $326 (1356% of Medicare)

Ins. Median: $104 (432% 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 432% of the Medicare baseline (a markup of 332%). 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
Medicare (plans)	$22 - $72	91%
Aetna	$23 - $315	96%
Highmark	$35 - $104	146%
Medicaid / KanCare	$40 - $122	166%
Blue_Cross	$183 - $262	761%
Cigna	$248 - $260	1031%
Wellspan_Capital_Blue_Cross	$260	1081%
Geisinger	$265	1102%
Independence_Blue_Cross	$265	1102%
Tower Health	$265 - $279	1102%
Upmc	$265 - $326	1102%
Phc	$285 - $289	1185%
First_Health_Network	$346	1439%
United_Healthcare	$384	1597%

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 $326.
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 Wellspan Ephrata 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.