CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: Southwestern Vermont Medical Center

Billing Code: 43239 (CPT)

The BaseRate · fair price medium confidence
A fair price for this
$282
about 0.3× the $927 Medicare rate · typically $137–$666
modeled estimate · not a bill or quote
What this hospital charges insurers
$349
Above the fair price
about $67 over the fair price · 0.4× Medicare
Medicare pays $927 Fair price $282 This hospital $349 Cash price $571 Hospital's list price $816

How we calculate the fair BaseRate →

How this hospital compares to other VT hospitals

A typical price — 4 charge more and 3 charge less, among the 8 VT hospitals compared.

Cheapest $168 Priciest $851

Black dot = this hospital, among the 8 VT hospitals with a price for this procedure. Full list below.

A fair price for a Upper endoscopy with biopsy is about $282 (about 0.3× the $927 Medicare rate). Southwestern Vermont Medical Center charges insurers about $349, or about $571 in cash — above the fair price. Located in Bennington, VT.

This price is above the fair BaseRate — you may be able to pay less

Ask the hospital for the cash / self-pay price, check whether you qualify for financial assistance, or negotiate the bill down toward the fair price of about $282. Many patients pay well below the first number they’re quoted — the checklists below walk you through it.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company Price range vs. Medicare
UnitedHealthcaremajor $100 - $957 11%
Blue Cross Blue Shieldmajor $126 - $957 14%
Aetnamajor $126 - $957 14%
Cignamajor $126 - $957 14%
Humanamajor $126 - $957 14%
CDPHP $88 - $957 9%
Fidelis Care $126 - $1,005 14%
Harvard Pilgrim $208 - $556 22%
MVP Health Care $95 - $957 10%
Tufts Health Plan $225 - $442 24%
WellCare $126 - $957 14%
+ 3 smaller / regional plans $109 - $957

Self-Pay How to get the cash price

Insurance Before you use insurance

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

Enter your details and press estimate to compare.

Facility Profile & Credentials

  • Address: 100 Hospital Drive, Bennington, VT 05201
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals