CMS Price Transparency Data

Blood test, lipase

Facility: Berkshire Medical Center

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83690
  • Insurance Median: $41
  • Cash Discount Price: $60
  • vs. Medicare Baseline: 5.95x Medicare
The contracted insurance negotiated median rate for a Blood test, lipase at Berkshire Medical Center is $41. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $60. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 5.95x the Medicare baseline. Located in 725 North Street, Pittsfield, MA.
Cash / Self-Pay
$60

Average discount available for prompt cash payment at this facility.

Insurance Median
$41

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$6.89

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $6.89 (100%)
Cash / Self-Pay: $60 (871%)
Insurance Median: $41 (595%)
Cash: $60 (871% of Medicare)
Ins. Median: $41 (595% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $6.89 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 595% of the Medicare baseline (a markup of 495%). 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
Cdphp $6 - $56 87%
Fallon $6 - $28 87%
Health New England $6 - $44 87%
Mbhp $6 87%
Mcd Out Of State $6 87%
Medicaid / KanCare $6 87%
Blue Cross Blue Shield $7 - $53 102%
Bmchnp $7 - $8 102%
Commcare Alliance $7 - $8 102%
Hospice $7 102%
Medicare (plans) $7 102%
Other Government $7 - $8 102%
Point32Health $7 - $60 102%
UnitedHealthcare $7 - $54 102%
Aetna $8 - $47 116%
Unicare $18 - $41 261%
Comm Tufts Qhpsub (Network) $35 - $38 508%
Workers Comp $38 552%
Allways Nhp $41 595%
Comm Hne Hmo $41 - $47 595%
Comm Hne Ppo $44 - $47 639%
Beacon $53 - $56 769%
Cigna $56 - $58 813%
Mvp $56 813%
Oxford $56 813%
First Health $58 - $60 842%
Connecticare $60 871%
Consolidated Health Plans $60 871%
Other Commercial $60 871%
Phcs $60 871%
Self Pay $60 871%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 725 North Street, Pittsfield, MA 01201
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals