CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Margaretville Memorial Hospital

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $6,872
  • Cash Discount Price: $15,279
  • vs. Medicare Baseline: 1.21x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Margaretville Memorial Hospital is $6,872. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $15,279. Compared to the federal Medicare reimbursement reference rate of $5,675.87, this hospital’s rate is 1.21x the Medicare baseline. Located in 42084 State Highway 28, Margaretville, NY.
Cash / Self-Pay
$15,279

Average discount available for prompt cash payment at this facility.

Insurance Median
$6,872

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$5,675.87

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $5,675.87 (100%)
Cash / Self-Pay: $15,279 (269%)
Insurance Median: $6,872 (121%)
Cash: $15,279 (269% of Medicare)
Ins. Median: $6,872 (121% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $5,675.87 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.

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
Todays Options $2,654 - $2,920 47%
Aetna $3,395 - $22,166 60%
Blue Cross Blue Shield $3,395 - $26,280 60%
Cdphp $3,395 - $3,735 60%
Hamaspik $3,395 60%
Magnacare $3,395 - $6,872 60%
Mvp $3,395 - $17,908 60%
Non Contracted $3,395 60%
UnitedHealthcare $3,395 - $20,882 60%
Wellcare $3,395 60%
Health First $3,633 64%
Emblem $18,404 - $31,797 324%
Oxford $18,794 - $20,882 331%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 42084 State Highway 28, Margaretville, NY 12455
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals