CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Berkshire Medical Center

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $89
  • Cash Discount Price: $94
  • vs. Medicare Baseline: 0.40x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Berkshire Medical Center is $89. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $94. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.40x the Medicare baseline. Located in 725 North Street, Pittsfield, MA.
Cash / Self-Pay
$94

Average discount available for prompt cash payment at this facility.

Insurance Median
$89

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$223.72

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $223.72 (100%)
Cash / Self-Pay: $94 (42%)
Insurance Median: $89 (40%)
Cash: $94 (42% of Medicare)
Ins. Median: $89 (40% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $223.72 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.

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 - $736 3%
Health New England $7 - $597 3%
Mcd Out Of State $7 - $147 3%
Medicaid / KanCare $7 - $147 3%
Bmchnp $8 - $192 4%
Comm Tufts Qhpsub (Network) $8 - $462 4%
Other Government $8 - $281 4%
Point32Health $8 - $777 4%
Blue Cross Blue Shield $9 - $695 4%
Commcare Alliance $9 - $332 4%
Hospice $9 - $281 4%
Medicare (plans) $9 - $277 4%
UnitedHealthcare $9 - $703 4%
Fallon $10 - $360 4%
Aetna $11 - $618 5%
Workers Comp $16 - $496 7%
Comm Hne Hmo $17 - $564 8%
Comm Hne Ppo $18 - $599 8%
Allways Nhp $39 - $529 17%
Unicare $40 - $530 18%
Beacon $52 - $736 23%
Cigna $55 - $761 25%
Mvp $55 - $736 25%
Oxford $55 - $736 25%
First Health $57 - $777 25%
Connecticare $58 - $777 26%
Consolidated Health Plans $58 - $777 26%
Other Commercial $58 - $777 26%
Phcs $58 - $777 26%
Self Pay $58 - $777 26%
Mbhp $147 66%

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