CMS Price Transparency Data

X-ray, lower back

Facility: Margaretville Memorial Hospital

Billing Code: 72110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72110
  • Insurance Median: $324
  • Cash Discount Price: $737
  • vs. Medicare Baseline: 3.03x Medicare
The contracted insurance negotiated median rate for a X-ray, lower back at Margaretville Memorial Hospital is $324. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $737. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 3.03x the Medicare baseline. Located in 42084 State Highway 28, Margaretville, NY.
Cash / Self-Pay
$737

Average discount available for prompt cash payment at this facility.

Insurance Median
$324

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: $737 (690%)
Insurance Median: $324 (303%)
Cash: $737 (690% of Medicare)
Ins. Median: $324 (303% 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 303% of the Medicare baseline (a markup of 203%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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 $121 - $737 113%
Mvp $165 154%
Emblem $166 - $196 155%
Oxford Exchange $179 168%
UnitedHealthcare $179 - $324 168%
Oxford $179 168%
Mvp Hmo/Ppo $195 183%
Blue Cross Blue Shield $214 - $324 200%
Self-Pay $308 288%
Medicare (plans) $324 - $486 303%
Mvp Gold (McR) $324 303%
Hamaspik (McR) $324 303%
Affinity By Molina McR $340 318%
Cdphp $357 334%
Emblem Ghi/Hip Ppo/Cbp $457 428%
Mvp Exchange $479 448%
Emblem Select Care (Exchange) $501 469%
Magnacare Standard $516 483%
Todays Options $535 501%
Magnacare Preferred $590 552%
Emblem Ghi/Hip Hmo/Epo/Pos $590 552%
Multiplan $604 565%
First Health $663 621%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 42084 State Highway 28, Margaretville, NY 12455
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals