CMS Price Transparency Data

Speech therapy (group session)

Facility: Astria Toppenish Hospital

Billing Code: 92508 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 92508
Insurance Median: $85
Cash Discount Price: $144
vs. Medicare Baseline: 3.53x Medicare

The contracted insurance negotiated median rate for a Speech therapy (group session) at Astria Toppenish Hospital is $85. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $144. Compared to the federal Medicare reimbursement reference rate of $24.05, this hospital’s rate is 3.53x the Medicare baseline. Located in 502 W Fourth Ave, Toppenish, WA.

Cash / Self-Pay

$144

Average discount available for prompt cash payment at this facility.

Insurance Median

$85

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: $144 (599%)

Insurance Median: $85 (353%)

Cash: $144 (599% of Medicare)

Ins. Median: $85 (353% 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 353% of the Medicare baseline (a markup of 253%). 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
Ambetter / Centene	$14	58%
Medicaid / KanCare	$14 - $43	58%
Medicare (plans)	$14 - $187	58%
Molina	$14	58%
UnitedHealthcare	$14 - $187	58%
Va	$14	58%
Molina_Exchange	$18	75%
Li	$24	100%
Aetna	$25 - $199	104%
Cigna	$25	104%
Humana	$25 - $226	104%
Tricare	$25	104%
Zenith	$25	104%
Regence	$74 - $77	308%
Premera	$82 - $85	341%
Premera_Affordable_Care	$82 - $85	341%
Kaiser	$92	383%
Chpw_Cascade_Care	$137 - $142	570%
First_Choice	$150 - $156	624%
Tpsc	$169 - $176	703%
Bcchp	$217 - $226	902%
Great_Rivers	$217 - $226	902%
Healthcomp	$217 - $226	902%
Washington_State_Hca	$217 - $226	902%

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 $144.
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 Astria Toppenish 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.