CMS Price Transparency Data

Sleep study (overnight, in lab)

Facility: Margaretville Memorial Hospital

Billing Code: 95810 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 95810
  • Insurance Median: $3,006
  • Cash Discount Price: $3,700
  • vs. Medicare Baseline: 3.43x Medicare
The contracted insurance negotiated median rate for a Sleep study (overnight, in lab) at Margaretville Memorial Hospital is $3,006. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,700. Compared to the federal Medicare reimbursement reference rate of $877.34, this hospital’s rate is 3.43x the Medicare baseline. Located in 42084 State Highway 28, Margaretville, NY.
Cash / Self-Pay
$3,700

Average discount available for prompt cash payment at this facility.

Insurance Median
$3,006

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$877.34

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $877.34 (100%)
Cash / Self-Pay: $3,700 (422%)
Insurance Median: $3,006 (343%)
Cash: $3,700 (422% of Medicare)
Ins. Median: $3,006 (343% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $877.34 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 343% of the Medicare baseline (a markup of 243%). 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
Hamaspik (McR) $1,628 - $22,000 186%
Medicare (plans) $1,628 - $23,540 186%
Mvp Gold (McR) $1,628 - $22,000 186%
Blue Cross Blue Shield $1,628 - $22,000 186%
UnitedHealthcare $1,628 - $22,000 186%
Aetna $1,628 - $22,000 186%
Affinity By Molina McR $1,709 - $23,100 195%
Emblem $1,737 - $5,927 198%
Cdphp $1,791 - $24,200 204%
Oxford Exchange $1,850 - $2,312 211%
Mvp $2,120 242%
Mvp Exchange $2,405 - $3,006 274%
Emblem Select Care (Exchange) $2,516 - $3,144 287%
Magnacare Standard $2,590 - $3,237 295%
Mvp Hmo/Ppo $2,623 299%
Emblem Ghi/Hip Ppo/Cbp $2,664 - $3,329 304%
Todays Options $2,686 - $3,357 306%
Emblem Ghi/Hip Hmo/Epo/Pos $2,960 - $3,699 337%
Magnacare Preferred $2,960 - $3,699 337%
Multiplan $3,034 - $3,792 346%
First Health $3,330 - $4,162 380%
Oxford $3,387 - $3,763 386%
Self-Pay $4,368 498%

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