CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Margaretville Memorial Hospital

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77067
Insurance Median: $396
Cash Discount Price: $652
vs. Medicare Baseline: 3.14x Medicare

The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Margaretville Memorial Hospital is $396. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $652. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 3.14x the Medicare baseline. Located in 42084 State Highway 28, Margaretville, NY.

Cash / Self-Pay

$652

Average discount available for prompt cash payment at this facility.

Insurance Median

$396

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$126.25

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $126.25 (100%)

Cash / Self-Pay: $652 (516%)

Insurance Median: $396 (314%)

Cash: $652 (516% of Medicare)

Ins. Median: $396 (314% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $126.25 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 314% of the Medicare baseline (a markup of 214%). 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	$77 - $570	61%
Self-Pay	$84	67%
Mvp Gold (McR)	$94	74%
Medicare (plans)	$94 - $617	74%
UnitedHealthcare	$94 - $160	74%
Aetna	$94 - $935	74%
Hamaspik (McR)	$94	74%
Affinity By Molina McR	$98	78%
Cdphp	$103	82%
Oxford	$160	127%
Mvp	$385	305%
Emblem	$394 - $463	312%
Emblem Ghi/Hip Ppo/Cbp	$404 - $580	320%
Mvp Exchange	$424 - $608	336%
Emblem Select Care (Exchange)	$443 - $636	351%
Mvp Hmo/Ppo	$454	360%
Magnacare Standard	$456 - $654	361%
Oxford Exchange	$456 - $654	361%
Todays Options	$473 - $679	375%
Emblem Ghi/Hip Hmo/Epo/Pos	$522 - $748	413%
Magnacare Preferred	$522 - $748	413%
Multiplan	$535 - $767	424%
First Health	$587 - $842	465%

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 $652.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 77067.

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 77067.
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.