CMS Price Transparency Data

Sepsis treatment (inpatient stay)

Facility: Margaretville Memorial Hospital

Billing Code: 871 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 871
  • Insurance Median: $5,303
  • Cash Discount Price: $15,279
  • vs. Medicare Baseline: 0.38x Medicare
The contracted insurance negotiated median rate for a Sepsis treatment (inpatient stay) at Margaretville Memorial Hospital is $5,303. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $15,279. Compared to the federal Medicare reimbursement reference rate of $14,116.91, this hospital’s rate is 0.38x the Medicare baseline. Located in 42084 State Highway 28, Margaretville, NY.
Cash / Self-Pay
$15,279

Average discount available for prompt cash payment at this facility.

Insurance Median
$5,303

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$14,116.91

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $14,116.91 (100%)
Cash / Self-Pay: $15,279 (108%)
Insurance Median: $5,303 (38%)
Cash: $15,279 (108% of Medicare)
Ins. Median: $5,303 (38% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $14,116.91 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.

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
Medicare (plans) $2,654 - $3,633 19%
Todays Options $2,654 - $2,920 19%
Blue Cross Blue Shield $3,395 - $68,963 24%
Non Contracted $3,395 24%
Mvp Gold (McR) $3,395 24%
Wellcare $3,395 24%
UnitedHealthcare $3,395 - $56,283 24%
Hamaspik $3,395 24%
Cdphp $3,395 - $3,735 24%
Aetna $3,395 - $55,743 24%
Mvp $3,395 - $45,035 24%
Hamaspik (McR) $3,395 24%
Magnacare $3,395 - $6,872 24%
Affinity By Molina McR $3,565 25%
Health First $3,633 26%
Magnacare Preferred $7,456 53%
Emblem $46,283 - $79,964 328%
Oxford $47,259 - $52,508 335%
Emblem Select Care (Exchange) $47,877 339%
Mvp Exchange $48,147 341%
Emblem Ghi/Hip Ppo/Cbp $53,900 382%
Emblem Ghi/Hip Hmo/Epo/Pos $56,327 399%
Mvp Hmo/Ppo $56,643 401%
Self-Pay $71,724 508%

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