CMS Price Transparency Data

Blood test, sodium

Facility: Berkshire Medical Center

Billing Code: 84295 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84295
Insurance Median: $28
Cash Discount Price: $42
vs. Medicare Baseline: 5.82x Medicare

The contracted insurance negotiated median rate for a Blood test, sodium at Berkshire Medical Center is $28. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $42. Compared to the federal Medicare reimbursement reference rate of $4.81, this hospital’s rate is 5.82x the Medicare baseline. Located in 725 North Street, Pittsfield, MA.

Cash / Self-Pay

$42

Average discount available for prompt cash payment at this facility.

Insurance Median

$28

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$4.81

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $4.81 (100%)

Cash / Self-Pay: $42 (873%)

Insurance Median: $28 (582%)

Cash: $42 (873% of Medicare)

Ins. Median: $28 (582% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $4.81 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 582% of the Medicare baseline (a markup of 482%). 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	$4 - $39	83%
Fallon	$4 - $19	83%
Health New England	$4 - $31	83%
Mbhp	$4	83%
Mcd Out Of State	$4	83%
Medicaid / KanCare	$4	83%
Blue Cross Blue Shield	$5 - $37	104%
Bmchnp	$5 - $6	104%
Commcare Alliance	$5 - $6	104%
Hospice	$5	104%
Medicare (plans)	$5	104%
Other Government	$5 - $6	104%
Point32Health	$5 - $42	104%
UnitedHealthcare	$5 - $38	104%
Aetna	$6 - $33	125%
Unicare	$12 - $28	249%
Comm Tufts Qhpsub (Network)	$25 - $27	520%
Workers Comp	$27	561%
Allways Nhp	$28	582%
Comm Hne Hmo	$29 - $33	603%
Comm Hne Ppo	$31 - $33	644%
Beacon	$37 - $39	769%
Cigna	$39 - $41	811%
Mvp	$39	811%
Oxford	$39	811%
First Health	$41 - $42	852%
Connecticare	$42	873%
Consolidated Health Plans	$42	873%
Other Commercial	$42	873%
Phcs	$42	873%
Self Pay	$42	873%

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 $42.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 84295.

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 84295.
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.