CMS Price Transparency Data

CT scan, head (with contrast)

Facility: Margaretville Memorial Hospital

Billing Code: 70460 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70460
Insurance Median: $1,194
Cash Discount Price: $2,713
vs. Medicare Baseline: 6.66x Medicare

The contracted insurance negotiated median rate for a CT scan, head (with contrast) at Margaretville Memorial Hospital is $1,194. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,713. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 6.66x the Medicare baseline. Located in 42084 State Highway 28, Margaretville, NY.

Cash / Self-Pay

$2,713

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,194

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$179.2

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $179.2 (100%)

Cash / Self-Pay: $2,713 (1514%)

Insurance Median: $1,194 (666%)

Cash: $2,713 (1514% of Medicare)

Ins. Median: $1,194 (666% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $179.2 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 666% of the Medicare baseline (a markup of 566%). 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	$292	163%
UnitedHealthcare	$292 - $1,194	163%
Aetna	$301 - $2,713	168%
Mvp	$413	230%
Emblem	$425 - $500	237%
Mvp Hmo/Ppo	$487	272%
Blue Cross Blue Shield	$1,075 - $1,655	600%
Hamaspik (McR)	$1,194	666%
Medicare (plans)	$1,194 - $1,791	666%
Mvp Gold (McR)	$1,194	666%
Affinity By Molina McR	$1,253	699%
Cdphp	$1,313	733%
Self-Pay	$1,544	862%
Emblem Ghi/Hip Ppo/Cbp	$1,682	939%
Mvp Exchange	$1,763	984%
Emblem Select Care (Exchange)	$1,845	1030%
Oxford Exchange	$1,899	1060%
Magnacare Standard	$1,899	1060%
Todays Options	$1,970	1099%
Magnacare Preferred	$2,170	1211%
Emblem Ghi/Hip Hmo/Epo/Pos	$2,170	1211%
Multiplan	$2,225	1242%
First Health	$2,442	1363%

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 $2,713.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 70460.

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 70460.
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.