CMS Price Transparency Data

Blood test, sodium

Facility: Margaretville Memorial Hospital

Billing Code: 84295 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84295
Insurance Median: $34
Cash Discount Price: $77
vs. Medicare Baseline: 7.07x Medicare

The contracted insurance negotiated median rate for a Blood test, sodium at Margaretville Memorial Hospital is $34. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $77. Compared to the federal Medicare reimbursement reference rate of $4.81, this hospital’s rate is 7.07x the Medicare baseline. Located in 42084 State Highway 28, Margaretville, NY.

Cash / Self-Pay

$77

Average discount available for prompt cash payment at this facility.

Insurance Median

$34

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$4.81

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $4.81 (100%)

Cash / Self-Pay: $77 (1601%)

Insurance Median: $34 (707%)

Cash: $77 (1601% of Medicare)

Ins. Median: $34 (707% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $4.81 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 707% of the Medicare baseline (a markup of 607%). 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	$7 - $34	146%
Oxford	$7	146%
Aetna	$13 - $77	270%
Mvp	$20	416%
Mvp Hmo/Ppo	$24	499%
Blue Cross Blue Shield	$28 - $38	582%
Mvp Gold (McR)	$34	707%
Hamaspik (McR)	$34	707%
Medicare (plans)	$34 - $51	707%
Affinity By Molina McR	$36	748%
Cdphp	$37	769%
Self-Pay	$41	852%
Emblem Ghi/Hip Ppo/Cbp	$48	998%
Mvp Exchange	$50	1040%
Emblem Select Care (Exchange)	$52	1081%
Oxford Exchange	$54	1123%
Magnacare Standard	$54	1123%
Todays Options	$56	1164%
Emblem Ghi/Hip Hmo/Epo/Pos	$62	1289%
Multiplan	$63	1310%
First Health	$69	1435%
Magnacare Preferred	$304	6320%

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 $77.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 84295.

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 84295.
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.