CMS Price Transparency Data

Behavioral health assessment

Facility: Margaretville Memorial Hospital

Billing Code: H0001 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: H0001
Insurance Median: $158
Cash Discount Price: $216
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a Behavioral health assessment at Margaretville Memorial Hospital is $158. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $216. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 42084 State Highway 28, Margaretville, NY.

Cash / Self-Pay

$216

Average discount available for prompt cash payment at this facility.

Insurance Median

$158

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

N/A

Standard federal government reimbursement rate for this code.

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
Mvp Gold (McR)	$95	N/A
Medicare (plans)	$95 - $210	N/A
Affinity By Molina McR	$100	N/A
Blue Cross Blue Shield	$123 - $190	N/A
Aetna	$127 - $160	N/A
Self-Pay	$134	N/A
Mvp Exchange	$140	N/A
Emblem Select Care (Exchange)	$147	N/A
Magnacare Standard	$151	N/A
Oxford Exchange	$151	N/A
Emblem Ghi/Hip Ppo/Cbp	$156	N/A
Todays Options	$157	N/A
Emblem Ghi/Hip Hmo/Epo/Pos	$173	N/A
Multiplan	$177	N/A
UnitedHealthcare	$190 - $384	N/A
First Health	$194	N/A
Hamaspik (McR)	$203	N/A
Cdphp	$209	N/A
Mvp	$647	N/A
Mvp Hmo/Ppo	$1,245	N/A

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 $216.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify HCPCS Code matches exactly: H0001.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Margaretville Memorial Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for HCPCS code H0001.
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.