Understanding Hospital Price Transparency

The charge description master (CDM) and payer-specific negotiated charges for Berkshire Medical Center and Fairview Hospital have been made available for your inspection pursuant to the Centers for Medicare and Medicaid (CMS) hospital price transparency rule effective January 1, 2021. This rule includes the requirement to provide pricing for 300 shoppable items, 70 of which have been mandated by CMS.  All patients should exercise caution when referencing this data and be aware of the resources available to help inform them of their specific healthcare costs. 

Please Note: The negotiated rates shown in the price transparency data do not reflect a patient’s out-of-pocket costs for any given treatment.

The rates between providers and insurers often do not translate into reliable information about expected out-of-pocket costs for patients. Out-of-pocket costs are dictated by specific benefit plans that are purchased by healthcare consumers. A patient’s costs will depend on the exact insurance policy held and how it applies to the specific services the patient is seeking.  Additionally, the price transparency documents do not account for  charity care or any state financial assistance programs for which a patient may qualify.  

We encourage patients to obtain an estimate of their specific out-of-pocket costs by calling their insurance company and/or by requesting an estimate from our financial specialist by calling 413-854-9605.  Before requesting an estimate, please visit the Helpful Patient Tools page to learn more about the specific information the financial specialist will need to estimate the costs.

Please remember that these cost figures do not contain any information on the high quality and safety of patient care in our hospitals. Our continued commitment to quality and safety are at the heart of our mission. 

Data in Context

The figures made available in this new display do not reflect all the complexities behind the costs listed. Hospital reimbursement methodologies and insurance contracts are extremely technical and cannot be represented in a single set of numbers. The amount that health plans pay providers depends on factors such as:

• how sick a patient is,
• whether or not a patient is receiving multiple treatments simultaneously, and
• whether or not the patient’s insurance plan covers the treatment.

In some cases, an insurer may have multiple products that offer different prices for the same service. When reviewing the CDM and shoppable services documents, a patient may see different prices for the same service, depending on the insurer.

There are many additional factors that influence the negotiated prices for services, including a hospital's level of support for physician practices in underserved areas, or a hospital's subsidy of critical services like behaviorial health or dialysis, so that the hospital can continue to provide comprehensive care to the community.

Please see Berkshire Medical Center Data and Fairview Hospital Data.

Get Help

Navigating the financial impact of your healthcare journey can seem daunting, but Berkshire Medical Center and Fairview Hospital are here to assist you. Please contact our financial specialist by calling 413-854-9605.