CMS Price Transparency Data

Diagnostic mammogram (both breasts)

Facility: Margaretville Memorial Hospital

Billing Code: 77066 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 77066
  • Insurance Median: $499
  • Cash Discount Price: $1,135
  • vs. Medicare Baseline: 3.18x Medicare
The contracted insurance negotiated median rate for a Diagnostic mammogram (both breasts) at Margaretville Memorial Hospital is $499. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,135. Compared to the federal Medicare reimbursement reference rate of $156.98, this hospital’s rate is 3.18x the Medicare baseline. Located in 42084 State Highway 28, Margaretville, NY.
Cash / Self-Pay
$1,135

Average discount available for prompt cash payment at this facility.

Insurance Median
$499

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$156.98

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $156.98 (100%)
Cash / Self-Pay: $1,135 (723%)
Insurance Median: $499 (318%)
Cash: $1,135 (723% of Medicare)
Ins. Median: $499 (318% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $156.98 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 318% of the Medicare baseline (a markup of 218%). 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.

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
Blue Cross Blue Shield $93 - $692 59%
Self-Pay $102 65%
Oxford $193 123%
UnitedHealthcare $193 - $499 123%
Aetna $379 - $1,135 241%
Mvp $467 297%
Emblem $474 - $558 302%
Medicare (plans) $499 - $749 318%
Hamaspik (McR) $499 318%
Mvp Gold (McR) $499 318%
Affinity By Molina McR $524 334%
Cdphp $549 350%
Mvp Hmo/Ppo $551 351%
Emblem Ghi/Hip Ppo/Cbp $704 448%
Mvp Exchange $738 470%
Emblem Select Care (Exchange) $772 492%
Magnacare Standard $794 506%
Oxford Exchange $794 506%
Todays Options $824 525%
Magnacare Preferred $908 578%
Emblem Ghi/Hip Hmo/Epo/Pos $908 578%
Multiplan $931 593%
First Health $1,022 651%

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