CMS Price Transparency Data

X-ray, foot

Facility: Margaretville Memorial Hospital

Billing Code: 73630 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73630
Insurance Median: $257
Cash Discount Price: $396
vs. Medicare Baseline: 2.89x Medicare

The contracted insurance negotiated median rate for a X-ray, foot at Margaretville Memorial Hospital is $257. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $396. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.89x the Medicare baseline. Located in 42084 State Highway 28, Margaretville, NY.

Cash / Self-Pay

$396

Average discount available for prompt cash payment at this facility.

Insurance Median

$257

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: $396 (445%)

Insurance Median: $257 (289%)

Cash: $396 (445% of Medicare)

Ins. Median: $257 (289% 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 289% of the Medicare baseline (a markup of 189%). 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	$80 - $594	90%
Mvp	$110	124%
Emblem	$113 - $132	127%
Blue Cross Blue Shield	$125 - $261	141%
UnitedHealthcare	$128 - $261	144%
Oxford Exchange	$128	144%
Oxford	$128	144%
Mvp Hmo/Ppo	$130	146%
Mvp Gold (McR)	$174 - $261	196%
Hamaspik (McR)	$174 - $261	196%
Medicare (plans)	$174 - $392	196%
Self-Pay	$180	202%
Affinity By Molina McR	$183 - $274	206%
Cdphp	$192 - $288	216%
Emblem Ghi/Hip Ppo/Cbp	$246 - $368	277%
Mvp Exchange	$257 - $386	289%
Emblem Select Care (Exchange)	$269 - $404	303%
Magnacare Standard	$277 - $416	312%
Todays Options	$288 - $431	324%
Magnacare Preferred	$317 - $475	357%
Emblem Ghi/Hip Hmo/Epo/Pos	$317 - $475	357%
Multiplan	$325 - $487	366%
First Health	$356 - $535	400%

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 $396.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 73630.

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 73630.
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.