CMS Price Transparency Data

Injection procedure for pain management

Facility: Margaretville Memorial Hospital

Billing Code: G0260 (HCPCS)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: G0260
  • Insurance Median: $22,000
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 30.51x Medicare
The contracted insurance negotiated median rate for a Injection procedure for pain management at Margaretville Memorial Hospital is $22,000. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $721.17, this hospital’s rate is 30.51x the Medicare baseline. Located in 42084 State Highway 28, Margaretville, NY.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$22,000

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$721.17

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $721.17 (100%)
Insurance Median: $22,000 (3051%)
Ins. Median: $22,000 (3051% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $721.17 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 3051% of the Medicare baseline (a markup of 2951%). 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.

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Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Aetna $2,394 - $22,000 332%
Blue Cross Blue Shield $2,909 - $22,000 403%
UnitedHealthcare $3,141 - $22,000 436%
Self-Pay $3,781 524%
Magnacare Preferred $4,021 558%
Mvp Gold (McR) $22,000 3051%
Medicare (plans) $22,000 - $23,540 3051%
Hamaspik (McR) $22,000 3051%
Affinity By Molina McR $23,100 3203%
Cdphp $24,200 3356%
Oxford Exchange $35,000 4853%

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