CMS Price Transparency Data

Blood antibody screen

Facility: Berkshire Medical Center

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $61
Cash Discount Price: $80
vs. Medicare Baseline: 1.15x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at Berkshire Medical Center is $61. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $80. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 1.15x the Medicare baseline. Located in 725 North Street, Pittsfield, MA.

Cash / Self-Pay

$80

Average discount available for prompt cash payment at this facility.

Insurance Median

$61

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$53.24

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $53.24 (100%)

Cash / Self-Pay: $80 (150%)

Insurance Median: $61 (115%)

Cash: $80 (150% of Medicare)

Ins. Median: $61 (115% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $53.24 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.

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
Fallon	$8 - $79	15%
Cdphp	$9 - $76	17%
Health New England	$9 - $68	17%
Mbhp	$9	17%
Mcd Out Of State	$9	17%
Medicaid / KanCare	$9	17%
Point32Health	$9 - $80	17%
Blue Cross Blue Shield	$10 - $72	19%
Bmchnp	$10 - $11	19%
Commcare Alliance	$10 - $79	19%
Hospice	$10 - $67	19%
Medicare (plans)	$10 - $66	19%
Other Government	$10 - $67	19%
Unicare	$10 - $55	19%
UnitedHealthcare	$10 - $73	19%
Aetna	$12 - $64	23%
Comm Tufts Qhpsub (Network)	$48 - $51	90%
Workers Comp	$51	96%
Allways Nhp	$55	103%
Comm Hne Hmo	$56 - $63	105%
Comm Hne Ppo	$59 - $63	111%
Beacon	$72 - $76	135%
Cigna	$76 - $79	143%
Mvp	$76	143%
Oxford	$76	143%
First Health	$79 - $80	148%
Connecticare	$80	150%
Consolidated Health Plans	$80	150%
Other Commercial	$80	150%
Phcs	$80	150%
Self Pay	$80	150%

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 $80.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 86850.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Berkshire Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 86850.
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.