CMS Price Transparency Data

Blood test, complete blood count (CBC)

Facility: Margaretville Memorial Hospital

Billing Code: 85025 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85025
Insurance Median: $58
Cash Discount Price: $132
vs. Medicare Baseline: 7.46x Medicare

The contracted insurance negotiated median rate for a Blood test, complete blood count (CBC) at Margaretville Memorial Hospital is $58. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $132. Compared to the federal Medicare reimbursement reference rate of $7.77, this hospital’s rate is 7.46x the Medicare baseline. Located in 42084 State Highway 28, Margaretville, NY.

Cash / Self-Pay

$132

Average discount available for prompt cash payment at this facility.

Insurance Median

$58

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$7.77

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $7.77 (100%)

Cash / Self-Pay: $132 (1699%)

Insurance Median: $58 (746%)

Cash: $132 (1699% of Medicare)

Ins. Median: $58 (746% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $7.77 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 746% of the Medicare baseline (a markup of 646%). 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
UnitedHealthcare	$12 - $58	154%
Oxford	$12	154%
Aetna	$21 - $132	270%
Mvp	$33	425%
Mvp Hmo/Ppo	$39	502%
Blue Cross Blue Shield	$46 - $61	592%
Hamaspik (McR)	$58	746%
Medicare (plans)	$58 - $87	746%
Mvp Gold (McR)	$58	746%
Affinity By Molina McR	$61	785%
Cdphp	$64	824%
Emblem Ghi/Hip Ppo/Cbp	$82	1055%
Mvp Exchange	$86	1107%
Emblem Select Care (Exchange)	$90	1158%
Magnacare Standard	$92	1184%
Oxford Exchange	$92	1184%
Todays Options	$96	1236%
Emblem Ghi/Hip Hmo/Epo/Pos	$106	1364%
Multiplan	$108	1390%
First Health	$119	1532%
Magnacare Preferred	$521	6705%

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 $132.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 85025.

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 CPT code 85025.
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.