CMS Price Transparency Data

X-ray, ankle

Facility: Margaretville Memorial Hospital

Billing Code: 73610 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73610
Insurance Median: $240
Cash Discount Price: $369
vs. Medicare Baseline: 2.70x Medicare

The contracted insurance negotiated median rate for a X-ray, ankle at Margaretville Memorial Hospital is $240. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $369. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.70x the Medicare baseline. Located in 42084 State Highway 28, Margaretville, NY.

Cash / Self-Pay

$369

Average discount available for prompt cash payment at this facility.

Insurance Median

$240

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$88.91

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $88.91 (100%)

Cash / Self-Pay: $369 (415%)

Insurance Median: $240 (270%)

Cash: $369 (415% of Medicare)

Ins. Median: $240 (270% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $88.91 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 270% of the Medicare baseline (a markup of 170%). 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
Aetna	$86 - $554	97%
Mvp	$118	133%
Emblem	$122 - $144	137%
UnitedHealthcare	$128 - $244	144%
Oxford	$128	144%
Oxford Exchange	$128	144%
Blue Cross Blue Shield	$129 - $244	145%
Mvp Hmo/Ppo	$139	156%
Mvp Gold (McR)	$162 - $244	182%
Hamaspik (McR)	$162 - $244	182%
Medicare (plans)	$162 - $366	182%
Affinity By Molina McR	$170 - $256	191%
Cdphp	$179 - $268	201%
Self-Pay	$185	208%
Emblem Ghi/Hip Ppo/Cbp	$229 - $343	258%
Mvp Exchange	$240 - $360	270%
Emblem Select Care (Exchange)	$251 - $377	282%
Magnacare Standard	$258 - $388	290%
Todays Options	$268 - $402	301%
Magnacare Preferred	$295 - $443	332%
Emblem Ghi/Hip Hmo/Epo/Pos	$295 - $443	332%
Multiplan	$303 - $454	341%
First Health	$332 - $499	373%

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 $369.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 73610.

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 73610.
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.