CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Central Vermont Medical Center

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99203
Insurance Median: $161
Cash Discount Price: $236
vs. Medicare Baseline: 1.37x Medicare

The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Central Vermont Medical Center is $161. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $236. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 1.37x the Medicare baseline. Located in Box 547, Barre, VT.

Cash / Self-Pay

$236

Average discount available for prompt cash payment at this facility.

Insurance Median

$161

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$117.57

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $117.57 (100%)

Cash / Self-Pay: $236 (201%)

Insurance Median: $161 (137%)

Cash: $236 (201% of Medicare)

Ins. Median: $161 (137% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $117.57 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.

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
Humana	$75 - $96	64%
Aetna	$77 - $108	65%
Coventry	$77 - $205	65%
Veterans Affairs Community Care Network	$77	65%
Blue Cross Blue Shield	$78 - $189	66%
Mvp	$78 - $273	66%
Cigna	$94 - $240	80%
Martins Point	$106 - $151	90%
UnitedHealthcare	$106 - $254	90%
Wellpath	$130 - $226	111%
Capital District Physicians' Health Plan	$171 - $189	145%
Harvard Pilgrim	$189 - $329	161%

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 $236.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 99203.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Central Vermont Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 99203.
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.