CMS Price Transparency Data

Blood test, basic metabolic panel

Facility: Berkshire Medical Center

Billing Code: 80048 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80048
Insurance Median: $53
Cash Discount Price: $78
vs. Medicare Baseline: 6.26x Medicare

The contracted insurance negotiated median rate for a Blood test, basic metabolic panel at Berkshire Medical Center is $53. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $78. Compared to the federal Medicare reimbursement reference rate of $8.46, this hospital’s rate is 6.26x the Medicare baseline. Located in 725 North Street, Pittsfield, MA.

Cash / Self-Pay

$78

Average discount available for prompt cash payment at this facility.

Insurance Median

$53

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$8.46

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $8.46 (100%)

Cash / Self-Pay: $78 (922%)

Insurance Median: $53 (626%)

Cash: $78 (922% of Medicare)

Ins. Median: $53 (626% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $8.46 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 626% of the Medicare baseline (a markup of 526%). 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
Cdphp	$7 - $73	83%
Health New England	$7 - $57	83%
Mcd Out Of State	$7 - $9	83%
Medicaid / KanCare	$7 - $9	83%
Hospice	$8	95%
Medicare (plans)	$8	95%
Other Government	$8 - $10	95%
Point32Health	$8 - $78	95%
UnitedHealthcare	$8 - $70	95%
Blue Cross Blue Shield	$9 - $69	106%
Bmchnp	$9 - $12	106%
Commcare Alliance	$9 - $10	106%
Fallon	$9 - $36	106%
Mbhp	$9	106%
Aetna	$10 - $62	118%
Unicare	$22 - $53	260%
Comm Tufts Qhpsub (Network)	$46 - $49	544%
Workers Comp	$50	591%
Allways Nhp	$53	626%
Comm Hne Hmo	$54 - $61	638%
Comm Hne Ppo	$57 - $61	674%
Beacon	$69 - $73	816%
Cigna	$73 - $76	863%
Mvp	$73	863%
Oxford	$73	863%
First Health	$76 - $78	898%
Connecticare	$78	922%
Consolidated Health Plans	$78	922%
Other Commercial	$78	922%
Phcs	$78	922%
Self Pay	$78	922%

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 $78.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 80048.

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 80048.
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.