CMS Price Transparency Data

Speech therapy (group session)

Facility: Prisma Health Oconee Memorial Hospital

Billing Code: 92508 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 92508
  • Insurance Median: $51
  • Cash Discount Price: $118
  • vs. Medicare Baseline: 2.12x Medicare
The contracted insurance negotiated median rate for a Speech therapy (group session) at Prisma Health Oconee Memorial Hospital is $51. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $118. Compared to the federal Medicare reimbursement reference rate of $24.05, this hospital’s rate is 2.12x the Medicare baseline. Located in 298 Memorial Dr, Seneca, SC.
Cash / Self-Pay
$118

Average discount available for prompt cash payment at this facility.

Insurance Median
$51

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: $118 (491%)
Insurance Median: $51 (212%)
Cash: $118 (491% of Medicare)
Ins. Median: $51 (212% 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 212% of the Medicare baseline (a markup of 112%). 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
Blue Cross Blue Shield $9 - $200 37%
Bluechoice [810] $10 - $270 42%
Medicaid / KanCare $11 - $78 46%
UnitedHealthcare $11 - $45 46%
Prisma Health Seniorcare Pace - Midlands [5400] $17 - $68 71%
Prisma Health Seniorcare Pace-Upstate [5200] $17 - $68 71%
Tricare $22 91%
Champva [3049] $23 96%
Cigna $23 - $510 96%
Covid19 Hrsa Uninsured Testing & Treatment Fund [904] $23 96%
Deseret Mutual Ins Co [3066] $23 96%
Generic Skilled Nursing [3196] $23 96%
Hospice Contracted [1500] $23 96%
Hospice Non Contracted [3190] $23 96%
Humana $23 - $79 96%
Medicare (plans) $23 - $74 96%
Triwest Healthcare Alliance Vcp [902] $23 96%
Va Community Care Network-Vaccn [903] $23 96%
Veterans Administration [3194] $23 96%
Aetna $24 - $230 100%
Golden Rule Insurance Company [2991] $24 100%
Healthy Conn Prime-First Choice Vip Care [5300] $24 100%
Healthy Conn Prime-Wellcare Prime By Atc [5310] $24 100%
Oxford Health Plans [2992] $24 100%
Zzumr-Salt Lake City Ut [3169] $24 100%
Healthy Conn Prime-Molina Healthcare [5330] $25 104%
Promise Health Plan Contracted [2401] $26 - $175 108%
Orangeburg Senior Helping Center Pace [5401] $29 - $116 121%
Workers Comp [600] $32 133%
Ambetter / Centene $42 175%
Bob Jones Univ-Pai [821] $44 - $175 183%
Meritain Health Contracted [2200] $47 - $230 195%
Preferred Administrators Contracted [2839] $51 - $204 212%
Sc Dept Of Corrections [2998] $52 216%
Scdc-Sc Dept Of Corrections [7232] $52 216%
Medcost [2940] $54 - $242 225%
Atlantic Packaging Contracted [4833] $55 - $218 229%
Aps Healthcare System [2981] $58 - $233 241%
Multiplan/Phcs Contracted [2950] $65 - $259 270%
Vsp Vision Care [2986] $66 - $262 274%
First Health Contracted [2952] $68 - $271 283%
Furman Int/Allen University Student [2951] $68 - $271 283%
Quiktrip-First Health [3067] $68 - $271 283%
First Choice Benefits Mgmt [3074] $73 - $74 304%
Evernorth Behavioral Contracted [2982] $188 - $510 782%
Mvp Health Care [3037] $188 - $510 782%
Planned Administrators [820] $200 832%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 298 Memorial Dr, Seneca, SC 29672
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals