CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: Berkshire Medical Center

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84153
Insurance Median: $109
Cash Discount Price: $159
vs. Medicare Baseline: 5.93x Medicare

The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at Berkshire Medical Center is $109. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $159. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 5.93x the Medicare baseline. Located in 725 North Street, Pittsfield, MA.

Cash / Self-Pay

$159

Average discount available for prompt cash payment at this facility.

Insurance Median

$109

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$18.39

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $18.39 (100%)

Cash / Self-Pay: $159 (865%)

Insurance Median: $109 (593%)

Cash: $159 (865% of Medicare)

Ins. Median: $109 (593% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $18.39 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 593% of the Medicare baseline (a markup of 493%). 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	$16 - $151	87%
Fallon	$16 - $74	87%
Health New England	$16 - $117	87%
Mbhp	$16	87%
Mcd Out Of State	$16	87%
Medicaid / KanCare	$16	87%
Hospice	$18	98%
Medicare (plans)	$18	98%
Other Government	$18 - $22	98%
Point32Health	$18 - $159	98%
UnitedHealthcare	$18 - $144	98%
Blue Cross Blue Shield	$19 - $142	103%
Bmchnp	$19 - $21	103%
Commcare Alliance	$19 - $22	103%
Aetna	$22 - $126	120%
Unicare	$48 - $109	261%
Comm Tufts Qhpsub (Network)	$95 - $101	517%
Workers Comp	$102	555%
Allways Nhp	$108	587%
Comm Hne Hmo	$110 - $126	598%
Comm Hne Ppo	$117 - $126	636%
Beacon	$142 - $151	772%
Cigna	$151 - $156	821%
Mvp	$151	821%
Oxford	$151	821%
First Health	$156 - $159	848%
Connecticare	$159	865%
Consolidated Health Plans	$159	865%
Other Commercial	$159	865%
Phcs	$159	865%
Self Pay	$159	865%

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 $159.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 84153.

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 84153.
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.