CMS Price Transparency Data

Colonoscopy with biopsy

Facility: Porter Hospital Inc

Billing Code: 45380 (CPT)

The BaseRate · fair price medium confidence
A fair price for this
$290
about 0.2× the $1,223 Medicare rate · typically $226–$1,185
modeled estimate · not a bill or quote
What this hospital charges insurers
$396
Above the fair price
about $106 over the fair price · 0.3× Medicare
Medicare pays $1,223 Fair price $290 This hospital $396 Cash price $2,181 Hospital's list price $2,181

How we calculate the fair BaseRate →

How this hospital compares to other VT hospitals

A typical price — 5 charge more and 3 charge less, among the 9 VT hospitals compared.

Cheapest $270 Priciest $967

Black dot = this hospital, among the 9 VT hospitals with a price for this procedure. Full list below.

⚠ The cash price looks unusually high next to the insurance price — it may be the full list price, not a real cash discount. Call to confirm the self-pay rate.

A fair price for a Colonoscopy with biopsy is about $290 (about 0.2× the $1,223 Medicare rate). Porter Hospital Inc charges insurers about $396, or about $2,181 in cash — above the fair price. Located in Middlebury, 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 $290. 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 $277 - $3,641 23%
Blue Cross Blue Shieldmajor $213 - $3,196 17%
Aetnamajor $185 - $3,237 15%
Cignamajor $677 - $3,345 55%
Humanamajor $176 - $1,120 14%
Fidelis Care $167 - $1,556 14%
Harvard Pilgrim $221 - $2,942 18%
MVP Health Care $157 - $3,428 13%
+ 3 smaller / regional plans $396 - $3,494
Government programs also on file: Military & VA.
Excludes 2 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

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.

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Facility Profile & Credentials

  • Address: 115 Porter Drive, Middlebury, VT 05753
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals