CMS Price Transparency Data

Ultrasound, abdomen (limited)

Facility: Margaretville Memorial Hospital

Billing Code: 76705 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76705
Insurance Median: $458
Cash Discount Price: $1,041
vs. Medicare Baseline: 4.29x Medicare

The contracted insurance negotiated median rate for a Ultrasound, abdomen (limited) at Margaretville Memorial Hospital is $458. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,041. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 4.29x the Medicare baseline. Located in 42084 State Highway 28, Margaretville, NY.

Cash / Self-Pay

$1,041

Average discount available for prompt cash payment at this facility.

Insurance Median

$458

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$106.81

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $106.81 (100%)

Cash / Self-Pay: $1,041 (975%)

Insurance Median: $458 (429%)

Cash: $1,041 (975% of Medicare)

Ins. Median: $458 (429% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $106.81 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 429% of the Medicare baseline (a markup of 329%). 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
UnitedHealthcare	$179 - $458	168%
Oxford	$179	168%
Aetna	$206 - $1,041	193%
Mvp	$249	233%
Emblem	$257 - $303	241%
Mvp Hmo/Ppo	$294	275%
Blue Cross Blue Shield	$418 - $556	391%
Hamaspik (McR)	$458	429%
Mvp Gold (McR)	$458	429%
Medicare (plans)	$458 - $687	429%
Affinity By Molina McR	$481	450%
Cdphp	$504	472%
Self-Pay	$600	562%
Emblem Ghi/Hip Ppo/Cbp	$645	604%
Mvp Exchange	$677	634%
Emblem Select Care (Exchange)	$708	663%
Magnacare Standard	$729	683%
Oxford Exchange	$729	683%
Todays Options	$756	708%
Emblem Ghi/Hip Hmo/Epo/Pos	$833	780%
Magnacare Preferred	$833	780%
Multiplan	$854	800%
First Health	$937	877%

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 $1,041.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 76705.

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 76705.
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.