CMS Price Transparency Data

X-ray, hand

Facility: Margaretville Memorial Hospital

Billing Code: 73130 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73130
Insurance Median: $243
Cash Discount Price: $374
vs. Medicare Baseline: 2.73x Medicare

The contracted insurance negotiated median rate for a X-ray, hand at Margaretville Memorial Hospital is $243. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $374. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.73x the Medicare baseline. Located in 42084 State Highway 28, Margaretville, NY.

Cash / Self-Pay

$374

Average discount available for prompt cash payment at this facility.

Insurance Median

$243

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: $374 (421%)

Insurance Median: $243 (273%)

Cash: $374 (421% of Medicare)

Ins. Median: $243 (273% 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 273% of the Medicare baseline (a markup of 173%). 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	$89 - $560	100%
Mvp	$121	136%
Emblem	$122 - $144	137%
Blue Cross Blue Shield	$127 - $246	143%
Oxford	$128	144%
Oxford Exchange	$128	144%
UnitedHealthcare	$128 - $246	144%
Mvp Hmo/Ppo	$143	161%
Hamaspik (McR)	$165 - $246	186%
Medicare (plans)	$165 - $370	186%
Mvp Gold (McR)	$165 - $246	186%
Affinity By Molina McR	$173 - $259	195%
Cdphp	$181 - $271	204%
Self-Pay	$183	206%
Emblem Ghi/Hip Ppo/Cbp	$232 - $347	261%
Mvp Exchange	$243 - $364	273%
Emblem Select Care (Exchange)	$254 - $381	286%
Magnacare Standard	$262 - $392	295%
Todays Options	$272 - $407	306%
Emblem Ghi/Hip Hmo/Epo/Pos	$299 - $448	336%
Magnacare Preferred	$299 - $448	336%
Multiplan	$307 - $459	345%
First Health	$337 - $504	379%

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 $374.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 73130.

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 73130.
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.