How many shoppable procedure prices are published for Gifford Medical Center?

Gifford Medical Center in Randolph, VT currently has 99 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do Gifford Medical Center's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, Gifford Medical Center's median negotiated commercial rate is 0.7× the regionally adjusted fair BaseRate benchmark.

What is Gifford Medical Center's CMS Care Compare overall star rating?

CMS Care Compare assigns Gifford Medical Center an overall hospital quality rating of 5 out of 5 stars based on public federal clinical and patient-experience measures.

Hospital Profile Critical Access Hospital Voluntary non-profit - Private 25 Beds · rural Updated: 2026-02-12

Gifford Medical Center

44 South Main Street, Randolph, VT 05060 · 99 Priced Procedures · 83% Patient Recommendation

CMS Overall Rating 5 / 5 Stars

Good Deal · Below Fair Market

0.65×vs. Fair Market Price

Typical commercial prices here are 35% below the fair benchmark (0.65×) after accounting for local nurse/doctor wages and patient complexity.

69/100 · Caution

69/100Self-Pay Cash Beats Insurance 70% of the Time

File Completeness51

Price Logic54

Peer Alignment65

Clean Billing85

Real Cash Discount100

Regional Value Leader

5-Star CMS clinical quality rating paired with 0.65× fair market pricing.

Behavioral Pricing FingerprintLow Shoppable & Low Captive Rates

Uniform Value Leader · Low-Cost Across Departments

Gifford Medical Center maintains low, disciplined commercial pricing across both routine shoppable procedures (0.8× Medicare, p50 0.46× Fair BaseRate) and emergency/ancillary services (1.1× Medicare, p75 1.08× Fair BaseRate). Both insured and self-pay patients benefit from below-benchmark rates across departments.

#2 of 11 in VT · 9th State Percentile#105 of 3,385 in U.S. · 3rd National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Elective shoppable care is priced 35% below peer Fair BaseRate (0.65×)
Self-pay cash beats commercial insurance on 70% of shoppable procedures (99/100 Cash Honesty)
5-Star CMS clinical rating with 83% patient recommendation (82/100 safety score)
IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (67.3% AGB cap)

Watchout

Where You Can Get Burned (Markup Traps)

Even at low-cost facilities (0.65× Fair BaseRate), out-of-network or unnegotiated chargemaster bills can exceed commercial medians — confirm in-network status or request a self-pay cash quote up front.
Captive ER (1.2×) & laboratory (1.9×) services average 1.38× higher multiples than routine shoppable care (0.8×)
Upper-quartile procedures (Q75 1.08×) jump +135% above the median procedure ratio (Q50 0.46×)
Consolidated metro market (HHI 6,176) limits in-network hospital competition (Highly Concentrated Monopoly (>2,500))

Front-Door ShoppableElective / Imaging

0.8× Medicare

Pre-scheduled outpatient procedures where patients can comparison-shop.

Back-Door Captive & ER1.38× Divergence

1.1× Medicare

Emergency, inpatient DRG, lab, and specialty drug lines billed after admission.

Quantile Tail Spread+135% Upper Tail

Q25 0.32× · Q50 0.46× · Q75 1.08×

Detects median-gaming when upper-quartile codes spike above the p50 median.

Select any lens to inspect department markups, federal cost accounting, or insurer discounts.

Department & Integrity Multiples (vs. CMS Medicare Cost Anchor) Green ≤1.3× · Teal 1.3–1.8× · Amber 1.8–2.5× · Rose >2.5×

Front-Door Shoppable CareFront-Door Shoppable

0.8× MedicareGood

Outpatient Surgery & ORBack-Door Captive

1.0× MedicareGood

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

0.9× MedicareGood

Back-Door Captive ER VisitsBack-Door Captive

1.2× MedicareGood

Inpatient Lab & PathologyBack-Door Captive

1.9× MedicareGood

Specialty & Infusion Drugs (J-Codes)Back-Door Captive

1.4× MedicareGood

Self-Pay Cash Honesty & 501(r)Integrity & Outcomes

70% Cash Edge · 99/100Good

CMS Clinical Safety & Star ValueIntegrity & Outcomes

5 CMS · 82/100Good

Procedure Prices at Gifford Medical Center

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 99 published procedures.

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Audit a Bill & 501(r) Cap ↓

Procedure & Billing Code	Self-Pay Cash	This Hospital	Fair BaseRate	vs. Fair
Vaginal delivery (full package) CPT Code: `59400`	$2,577	$2,800	$2,680	1.0×
C-section delivery (full package) CPT Code: `59510`	$2,576	$2,800	$2,975	0.9×
Total knee replacement CPT Code: `27447`	$1,808	$1,808	$13,523	0.1×
Total hip replacement CPT Code: `27130`	$1,705	$1,705	$13,413	0.1×
MRI, brain (with and without contrast) CPT Code: `70553`	$1,224	$954	$511	1.9×
Gallbladder removal (laparoscopic) CPT Code: `47562`	$750	$861	$6,109	0.1×
Rabies immune globulin HCPCS Code: `90375`	$1,412	$797	$322	2.5×
Bunion correction surgery CPT Code: `28296`	$879	$760	$3,446	0.2×
Knee arthroscopy with meniscus repair CPT Code: `29881`	$680	$731	$3,372	0.2×
Inguinal hernia repair CPT Code: `49505`	$650	$686	$3,629	0.2×
MRI, knee or other leg joint CPT Code: `73721`	$846	$627	$369	1.7×
MRI, brain (no contrast) CPT Code: `70551`	$878	$573	$343	1.7×
Blood transfusion CPT Code: `36430`	$593	$593	$498	1.2×
Breast lump removal CPT Code: `19120`	$2,821	$552	$3,875	0.1×
X-ray, hand CPT Code: `73130`	$261	$261	$93	2.8×
X-ray, hip CPT Code: `73502`	$243	$243	$93	2.6×
X-ray, ankle CPT Code: `73610`	$237	$237	$93	2.5×
Colonoscopy (diagnostic) CPT Code: `45378`	$355	$262	$981	0.3×
Colonoscopy with biopsy CPT Code: `45380`	$479	$285	$1,256	0.2×
X-ray, foot CPT Code: `73630`	$241	$241	$92	2.6×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$1,209	$264	$583	0.5×
X-ray, shoulder CPT Code: `73030`	$233	$233	$92	2.5×
Speech therapy (language evaluation) CPT Code: `92507`	$174	$174	$86	2.0×
Upper endoscopy with biopsy CPT Code: `43239`	$452	$197	$987	0.2×
Ultrasound, pelvis CPT Code: `76856`	$390	$154	$130	1.2×
Office visit, established patient (30-39 min) CPT Code: `99214`	$115	$122	$123	1.0×
Physical therapy (functional capacity test) CPT Code: `97750`	$87	$87	$38	2.3×
Prosthetic fitting and training CPT Code: `97761`	$96	$96	$45	2.1×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$82	$82	$40	2.0×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$100	$100	$64	1.6×
Office visit, established patient (20-29 min) CPT Code: `99213`	$79	$87	$87	1.0×
New patient office visit (30-44 min) CPT Code: `99203`	$132	$106	$110	1.0×
X-ray, lower back CPT Code: `72110`	$86	$86	$112	0.8×
Breathing treatment (nebulizer) CPT Code: `94640`	$98	$98	$201	0.5×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$126	$103	$303	0.3×
CT scan, head (with and without contrast) CPT Code: `70470`	$115	$87	$258	0.3×
MRI, lower back (no contrast) CPT Code: `72148`	$108	$107	$338	0.3×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$132	$109	$448	0.2×
Typhoid vaccine HCPCS Code: `90675`	$917	$374	$347	1.1×
Drug screening test HCPCS Code: `G0480`	$104	$148	$116	1.3×
Pneumococcal vaccine HCPCS Code: `90732`	—	—	$140	—
Culture, blood CPT Code: `87040`	$78	$78	$11	7.1×
Blood test, thyroid (TSH) CPT Code: `84443`	$97	$97	$18	5.4×
Hepatitis C antibody test CPT Code: `86803`	$78	$78	$15	5.2×
Prostate cancer screening (blood test) HCPCS Code: `G0103`	$80	$80	$20	4.0×
Blood test, clotting time (PTT) CPT Code: `85730`	$45	$45	$6	7.5×
Blood test, amylase CPT Code: `82150`	$50	$50	$7	7.1×
Blood test, magnesium CPT Code: `83735`	$49	$49	$7	7.0×
Blood test, ferritin (iron stores) CPT Code: `82728`	$61	$61	$14	4.4×
Blood test, potassium CPT Code: `84132`	$35	$35	$5	7.0×
Blood test, liver function panel CPT Code: `80076`	$60	$60	$9	6.7×
Blood test, calcium CPT Code: `82310`	$34	$34	$5	6.8×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$58	$58	$11	5.3×
Blood test, hemoglobin CPT Code: `85018`	$18	$18	$3	6.0×
Blood test, lipase CPT Code: `83690`	$41	$41	$7	5.9×
Blood test, complete blood count (CBC) CPT Code: `85025`	$42	$42	$8	5.3×
Blood test, vitamin B12 CPT Code: `82607`	$56	$56	$16	3.5×
Physical therapy (gait training) CPT Code: `97116`	$59	$59	$33	1.8×
Diagnostic procedure preparation HCPCS Code: `G0279`	$67	$59	$35	1.7×
Occupational therapy (self-care training) CPT Code: `97535`	$55	$55	$38	1.4×
X-ray, pelvis CPT Code: `72170`	$65	$65	$110	0.6×
CT scan, pelvis CPT Code: `72192`	$79	$75	$163	0.5×
Diagnostic mammogram (both breasts) CPT Code: `77066`	$72	$67	$148	0.5×
CT scan, chest (no contrast) CPT Code: `71250`	$105	$74	$167	0.4×
Screening mammogram (both breasts) CPT Code: `77067`	$236	$52	$123	0.4×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$72	$69	$168	0.4×
CT scan, neck (cervical spine) CPT Code: `72125`	$105	$69	$169	0.4×
X-ray, neck (cervical spine) CPT Code: `72040`	$128	$38	$93	0.4×
Ultrasound, abdomen (complete) CPT Code: `76700`	$57	$54	$134	0.4×
X-ray, chest (single view) CPT Code: `71045`	$37	$37	$92	0.4×
CT scan, head (no contrast) CPT Code: `70450`	$77	$59	$160	0.4×
CT scan, sinuses CPT Code: `70486`	$130	$59	$166	0.4×
CT scan, head (with contrast) CPT Code: `70460`	$102	$78	$242	0.3×
Orthotic fitting and training CPT Code: `97760`	$26	$49	$51	1.0×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	$143	$51	$56	0.9×
Ultrasound, leg veins (duplex) CPT Code: `93970`	$48	$48	$272	0.2×
Blood test, glucose (blood sugar) CPT Code: `82947`	$21	$21	$4	5.3×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$21	$21	$4	5.3×
Blood test, creatinine (kidney) CPT Code: `82565`	$25	$25	$5	5.0×
Blood test, sodium CPT Code: `84295`	$23	$23	$5	4.6×
Electrical stimulation therapy HCPCS Code: `G0283`	$26	$26	$14	1.9×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$52	$12	$10	1.2×
Blood test, PSA (prostate screen) CPT Code: `84153`	$80	$22	$19	1.2×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$57	$16	$14	1.1×
Blood test, vitamin D CPT Code: `82306`	$110	$35	$31	1.1×
X-ray, chest (two views) CPT Code: `71046`	$133	$32	$93	0.3×
Ultrasound, abdomen (limited) CPT Code: `76705`	$131	$40	$126	0.3×
Ultrasound, thyroid and neck CPT Code: `76536`	$148	$38	$132	0.3×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$40	$4	$3	1.3×
Blood test, basic metabolic panel CPT Code: `80048`	$44	$10	$9	1.1×
Culture, bacterial CPT Code: `87070`	$84	$10	$9	1.1×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$57	$35	$38	0.9×
Hospital observation (per hour) HCPCS Code: `G0378`	$49	$49	$86	0.6×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$27	$5	$5	1.0×
Physical therapy (manual therapy) CPT Code: `97140`	$71	$30	$34	0.9×
Electrocardiogram (ECG/EKG) CPT Code: `93000`	$113	$19	$25	0.8×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$17	$17	$35	0.5×
Blood antibody screen CPT Code: `86850`	$81	$13	$46	0.3×
Flu vaccine (high dose) HCPCS Code: `90656`	$7	$7	$25	0.3×

Showing top 25 high-impact procedures of 99 total

Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 67.3%

Audit a Bill or Quote at Gifford Medical Center (Zero PHI Required)

CMS CCN: 471301

CPT 59400

Select Procedure to Audit:

Fair BaseRate™ $2,680

Medicare Rate $2,214

Self-Pay Cash $2,577

Insurer Median $2,800

1. Amount on Your Bill or Quote ($) Pre-filled with Gifford Medical Center’s charged/list benchmark

2. Household Annual Income ($) Screened against 2026 HHS Federal Poverty Guidelines

3. Household Size (1–8) 2026 FPL: $15,650 + $5,500 per additional person

Step 1 · 501(r) Charity Care Check 501(r) AGB Cap: $3,468 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $3,468

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (67.3% of gross = $3,468).

Step 2 · Cash vs. Insurance Arbitrage Save $2,576 Paying Cash

Self-Pay Cash Rate ($2,577) Beats Your Bill

Gifford Medical Center's published 45 CFR § 180 self-pay cash rate is $2,577 (vs. $2,800 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.

Step 3 · Fair BaseRate Target +$2,473 Above Fair BaseRate

Negotiate Toward $2,680 Fair BaseRate ($2,214 Medicare)

Your bill ($5,153) is $2,473 above the denoised Fair BaseRate ($2,680) and 2.3× the $2,214 Medicare rate.

1-Click Factual Dispute Summary: Copy a citation-backed benchmark memo (with CMS CCN, CPT code, Medicare reference, Fair BaseRate, and 26 U.S.C. § 501(r) calculations) to paste into patient-portal messages or billing appeals.

IRS Form 990 Schedule H & 26 U.S.C. § 501(r) 501(c)(3) Nonprofit Hospital

Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)

EIN: 030179418

Filing Period: 193703

Free Care Eligibility BenchmarkUp to 200% FPL100% charity write-off income threshold

Discounted Care EligibilityUp to 400% FPLSliding-scale & AGB billing cap tier

Charity Care Share of ExpensesSee Schedule HNet community financial assistance reported

26 U.S.C. § 501(r)(5) AGB Benchmark Method: lookback_commercial_median

Hospital-Specific CMS HCRIS Benchmark (67.3% of gross charges)

Under 26 U.S.C. § 501(r)(5), a tax-exempt hospital organization may not bill FAP-eligible patients more than Amounts Generally Billed (AGB) to individuals with insurance covering emergency or medically necessary care. Derived from this facility’s reported CMS HCRIS cost-to-charge & insurer allowance filings. Verify your exact Financial Assistance Policy (FAP) determination directly with the billing office.

Screen your household size, income, and itemized CPT codes against 2026 HHS Federal Poverty Guidelines: Calculate Your 501(r) Cap Above ↑

CMS Care Compare Public Quality Record

Clinical Quality, Patient Experience & Infection Benchmarks

CMS Overall5/5 Stars (5/5)

Safety Composite82/100

Would Recommend83%

Rated 9 or 10 (HCAHPS)81%

30-Day Mortality vs U.S.same

Unplanned Readmissionsame

Healthcare-Associated Infections (CDC NHSN / CMS HAI)

1.00 SIR = National Predicted Baseline (Lower Is Safer)

C. diff Hospital-Onset Infectionsame

CMS Price Transparency Administrative Enforcement Log

Factual public administrative actions published by the Centers for Medicare & Medicaid Services regarding 45 CFR § 180 compliance at Gifford Medical Center. Prior administrative notices do not necessarily reflect current compliance status.

2023-10-16·administrative_or_closure
Closure Notice
Recorded
2023-09-28·cap_corrective_action
CAP Request
Recorded
2023-06-13·warning_notice
Warning Notice
Recorded

Source: CMS Hospital Care Compare (156 completed HCAHPS patient surveys). Clinical quality metrics summarize historical facility-wide cohorts and are not medical advice for individual care decisions.

Care-Setting Arbitrage, Bilateral SVD Insurer Leverage & Regional Alternatives

How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings

Regional Value & Quality Leader Pareto Frontier (Price + Quality)

2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Gifford Medical Center.

Price Index: 0.67× regional baseline

Quality: 81/100 CMS composite

Median Household Income$77,328U.S. Census ACS

Local Uninsured Share5.2%Regional ACS estimate

200% FPL (1 Person)$31,920Common free-care ceiling

400% FPL (Family of 4)$128,600Common AGB cap ceiling

45 CFR § 180 Primary-Source Lineage & Federal Verification VeriRate 69/100 · Caution CMS CCN 471301 EIN 030179418

Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings

MRF Portal Indexed (CMS_45_CFR_180_FILING.json) Verify on CMS Medicare.gov (CCN 471301) ↗ Verify IRS Form 990 (EIN 030179418) ↗ CMS HCRIS Cost Reports ↗

Published MRF FileCMS_45_CFR_180_FILING.json

Publication / Vintage2026-02-12

Validated Rate Rows4,260 (CMS v3.0.0)

File Integrity DigestVerified · CCN 471301

Safe-Harbor Data Corrections: Parsed directly from public 45 CFR § 180 hospital filings, CMS Care Compare, and CMS HCRIS cost reports. Hospital compliance officers may submit updated MRF URLs or rate tables for verification.

Submit MRF Update Correction Policy