CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Margaretville Memorial Hospital

Billing Code: 392 (MS-DRG)

The BaseRate · fair price high confidence

A fair price for this

$8,861

about 1.6× the $5,676 Medicare rate · typically $4,891–$13,391

modeled estimate · not a bill or quote

Medicare pays $5,676 Fair price $8,861 Cash price $15,279 Hospital's list price $19,367

How we calculate the fair BaseRate →

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

3 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna CignaHumanaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$3,395 - $22,383	60%
Blue Cross Blue Shieldmajor	$3,395 - $27,677	60%
Aetnamajor	$3,395 - $22,166	60%
CDPHP	$3,395 - $3,735	60%
MagnaCare	$3,395 - $7,456	60%
Molina	$3,565	63%
MVP Health Care	$3,395 - $19,323	60%
WellCare	$3,395	60%
+ 9 smaller / regional plans	$2,654 - $31,797

Government programs also on file: Medicare.

Excludes 2 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 15,279), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the MS-DRG code on your bill matches exactly: 392.

Insurance Before you use insurance

Call your insurance company to confirm Margaretville Memorial Hospital is in-network.
Ask your insurer whether prior approval is required for MS-DRG code 392.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Margaretville Memorial Hospital

Compare: Digestive disorders treatment (inpatient stay) at other NY hospitals

Sisters of Charity Hospital · Buffalo $5,103
Mercy Hospital of Buffalo · Buffalo $5,610
Kenmore Mercy Hospital · Kenmore $5,857
Community Memorial Hospital, Inc · Hamilton $6,210
United Memorial Medical Center · Batavia $6,279
Montefiore St Luke's Cornwall · Newburgh $6,673
Montefiore Mount Vernon Hospital · Mount Vernon $6,829
Montefiore New Rochelle Hospital · New Rochelle $6,861

Insurance negotiated median for the same procedure, sorted lowest first.