CMS Price Transparency Data

Trauma team activation

Facility: Margaretville Memorial Hospital

Billing Code: G0390 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: G0390
Insurance Median: $2,957
Cash Discount Price: $5,379
vs. Medicare Baseline: 2.17x Medicare

The contracted insurance negotiated median rate for a Trauma team activation at Margaretville Memorial Hospital is $2,957. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,379. Compared to the federal Medicare reimbursement reference rate of $1,361.78, this hospital’s rate is 2.17x the Medicare baseline. Located in 42084 State Highway 28, Margaretville, NY.

Cash / Self-Pay

$5,379

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,957

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$1,361.78

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $1,361.78 (100%)

Cash / Self-Pay: $5,379 (395%)

Insurance Median: $2,957 (217%)

Cash: $5,379 (395% of Medicare)

Ins. Median: $2,957 (217% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $1,361.78 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 217% of the Medicare baseline (a markup of 117%). 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
Hamaspik (McR)	$1,247 - $22,000	92%
Blue Cross Blue Shield	$1,247 - $22,000	92%
Medicare (plans)	$1,247 - $23,540	92%
Mvp Gold (McR)	$1,247 - $22,000	92%
UnitedHealthcare	$1,247 - $22,000	92%
Aetna	$1,247 - $22,000	92%
Affinity By Molina McR	$1,310 - $23,100	96%
Cdphp	$1,372 - $24,200	101%
Oxford Exchange	$1,508 - $18,550	111%
Mvp Hmo/Ppo	$1,581 - $17,225	116%
Mvp Exchange	$1,843 - $17,225	135%
Emblem Select Care (Exchange)	$1,928 - $18,020	142%
Magnacare Standard	$1,984 - $18,550	146%
Emblem Ghi/Hip Ppo/Cbp	$2,041 - $19,080	150%
Todays Options	$2,058 - $19,239	151%
Self-Pay	$2,138 - $20,272	157%
Magnacare Preferred	$2,267 - $21,200	166%
Emblem Ghi/Hip Hmo/Epo/Pos	$2,268 - $21,200	167%
Multiplan	$2,325 - $21,730	171%
First Health	$2,552 - $23,850	187%

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 $5,379.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify HCPCS Code matches exactly: G0390.

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 G0390.
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.