CMS Price Transparency Data

Drug screening test

Facility: Margaretville Memorial Hospital

Billing Code: G0480 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: G0480
Insurance Median: $238
Cash Discount Price: $535
vs. Medicare Baseline: 2.08x Medicare

The contracted insurance negotiated median rate for a Drug screening test at Margaretville Memorial Hospital is $238. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $535. Compared to the federal Medicare reimbursement reference rate of $114.43, this hospital’s rate is 2.08x the Medicare baseline. Located in 42084 State Highway 28, Margaretville, NY.

Cash / Self-Pay

$535

Average discount available for prompt cash payment at this facility.

Insurance Median

$238

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$114.43

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $114.43 (100%)

Cash / Self-Pay: $535 (468%)

Insurance Median: $238 (208%)

Cash: $535 (468% of Medicare)

Ins. Median: $238 (208% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $114.43 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 208% of the Medicare baseline (a markup of 108%). 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
Blue Cross Blue Shield	$57 - $326	50%
Self-Pay	$63	55%
UnitedHealthcare	$172 - $235	150%
Oxford	$172	150%
Medicare (plans)	$235 - $353	205%
Hamaspik (McR)	$235	205%
Mvp Gold (McR)	$235	205%
Aetna	$235 - $535	205%
Affinity By Molina McR	$247	216%
Cdphp	$259	226%
Emblem Ghi/Hip Ppo/Cbp	$332	290%
Mvp Exchange	$348	304%
Emblem Select Care (Exchange)	$364	318%
Oxford Exchange	$374	327%
Magnacare Standard	$374	327%
Todays Options	$388	339%
Emblem Ghi/Hip Hmo/Epo/Pos	$428	374%
Multiplan	$439	384%
First Health	$482	421%
Mvp	$486	425%
Mvp Hmo/Ppo	$573	501%
Magnacare Preferred	$2,113	1847%

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 $535.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify HCPCS Code matches exactly: G0480.

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 HCPCS code G0480.
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.