CMS Price Transparency Data

Blood test, hemoglobin

Facility: Margaretville Memorial Hospital

Billing Code: 85018 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 85018
Insurance Median: $39
Cash Discount Price: $88
vs. Medicare Baseline: 16.46x Medicare

The contracted insurance negotiated median rate for a Blood test, hemoglobin at Margaretville Memorial Hospital is $39. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $88. Compared to the federal Medicare reimbursement reference rate of $2.37, this hospital’s rate is 16.46x the Medicare baseline. Located in 42084 State Highway 28, Margaretville, NY.

Cash / Self-Pay

$88

Average discount available for prompt cash payment at this facility.

Insurance Median

$39

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$2.37

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $2.37 (100%)

Cash / Self-Pay: $88 (3713%)

Insurance Median: $39 (1646%)

Cash: $88 (3713% of Medicare)

Ins. Median: $39 (1646% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $2.37 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 1646% of the Medicare baseline (a markup of 1546%). 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
Oxford	$4	169%
UnitedHealthcare	$4 - $39	169%
Aetna	$6 - $88	253%
Mvp	$10	422%
Mvp Hmo/Ppo	$12	506%
Blue Cross Blue Shield	$14 - $39	591%
Self-Pay	$20	844%
Hamaspik (McR)	$39	1646%
Medicare (plans)	$39 - $58	1646%
Mvp Gold (McR)	$39	1646%
Affinity By Molina McR	$41	1730%
Cdphp	$43	1814%
Emblem Ghi/Hip Ppo/Cbp	$55	2321%
Mvp Exchange	$57	2405%
Emblem Select Care (Exchange)	$60	2532%
Oxford Exchange	$62	2616%
Magnacare Standard	$62	2616%
Todays Options	$64	2700%
Emblem Ghi/Hip Hmo/Epo/Pos	$70	2954%
Multiplan	$72	3038%
First Health	$79	3333%
Magnacare Preferred	$348	14684%

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 $88.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 85018.

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 85018.
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.