CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: Porter Hospital Inc

Billing Code: 99213 (CPT)

The BaseRate · fair price medium confidence
A fair price for this
$74
about 0.8× the $95 Medicare rate · typically $41–$140
modeled estimate · not a bill or quote
What this hospital charges insurers
$86
Above the fair price
about $12 over the fair price · 0.9× Medicare
Medicare pays $95 Fair price $74 This hospital $86 Cash price $207 Hospital's list price $207

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 $70 Priciest $96

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

A fair price for a Office visit, established patient (20-29 min) is about $74 (about 0.8× the $95 Medicare rate). Porter Hospital Inc charges insurers about $86, or about $207 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 $74. 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 $64 - $244 67%
Blue Cross Blue Shieldmajor $71 - $192 75%
Aetnamajor $62 - $216 65%
Cignamajor $78 - $224 82%
Humanamajor $59 62%
Fidelis Care $56 - $104 59%
Harvard Pilgrim $73 - $197 77%
MVP Health Care $53 - $229 56%
+ 3 smaller / regional plans $86 - $234
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.

Enter your details and press estimate to compare.

Facility Profile & Credentials

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