How many shoppable procedure prices are published for Porter Hospital Inc?

Porter Hospital Inc in Middlebury, VT currently has 118 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do Porter Hospital Inc's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, Porter Hospital Inc's median negotiated commercial rate is 0.8× the regionally adjusted fair BaseRate benchmark.

What is Porter Hospital Inc's CMS Care Compare overall star rating?

CMS Care Compare assigns Porter Hospital Inc an overall hospital quality rating of 3 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: 2026-04-28

Porter Hospital Inc

115 Porter Drive, Middlebury, VT 05753 · 118 Priced Procedures · 65% Patient Recommendation

CMS Overall Rating 3 / 5 Stars

Good Deal · Below Fair Market

0.78×vs. Fair Market Price

Typical commercial prices here are 22% below the fair benchmark (0.78×) after accounting for local nurse/doctor wages and patient complexity.

58/100 · Caution

58/100Self-Pay Cash Beats Insurance 29% of the Time

File Completeness66

Price Logic51

Peer Alignment66

Clean Billing87

Real Cash Discount19

Regional Benchmark Tier

3-Star CMS clinical quality rating paired with 0.78× fair market pricing.

Behavioral Pricing FingerprintMedian-Gamed · High Captive Markup

Loss-Leader / Captive Ancillary Cross-Subsidizer

Porter Hospital Inc prices routine shoppable procedures near 0.9× Medicare (p50 0.69×) while skewing captive emergency, lab, and upper-quartile codes to 1.8× Medicare (p75 1.19×, +72% upper-tail jump). Patients scheduling elective outpatient care can capture competitive rates, but emergency and ancillary bills require strict line-item auditing.

#4 of 11 in VT · 27th State Percentile#242 of 3,385 in U.S. · 7th National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Elective shoppable care is priced 22% below peer Fair BaseRate (0.78×)
Self-pay cash beats commercial insurance on 29% of shoppable procedures (25/100 Cash Honesty)
CMS clinical safety score (64/100 safety score) with 65% patient recommendation
IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (43.5% AGB cap)

Watchout

Where You Can Get Burned (Markup Traps)

Even at low-cost facilities (0.78× 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 (1.3×) & laboratory (1.9×) services average 2.00× higher multiples than routine shoppable care (0.9×)
Upper-quartile procedures (Q75 1.19×) jump +72% above the median procedure ratio (Q50 0.69×)
Consolidated metro market (HHI 2,509) limits in-network hospital competition (Highly Concentrated Monopoly (>2,500))

Front-Door ShoppableElective / Imaging

0.9× Medicare

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

Back-Door Captive & ER2.00× Divergence

1.8× Medicare

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

Quantile Tail Spread+72% Upper Tail

Q25 0.28× · Q50 0.69× · Q75 1.19×

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

0.9× MedicareGood

Outpatient Surgery & ORBack-Door Captive

0.5× MedicareGood

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

1.2× MedicareGood

Back-Door Captive ER VisitsBack-Door Captive

1.3× MedicareGood

Inpatient Lab & PathologyBack-Door Captive

1.9× MedicareGood

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

1.1× MedicareGood

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

29% Cash Edge · 25/100Watchout

CMS Clinical Safety & Star ValueIntegrity & Outcomes

3 CMS · 64/100Elevated

Procedure Prices at Porter Hospital Inc

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 118 published procedures.

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Audit a Bill & 501(r) Cap ↓

Procedure & Billing Code	Self-Pay Cash	This Hospital	Fair BaseRate	vs. Fair
Spinal fusion, single level (inpatient stay) MS-DRG Code: `451`	—	$38,581	$30,775	1.3×
Sepsis treatment (inpatient stay) MS-DRG Code: `871`	—	$24,530	$19,087	1.3×
Hip or knee replacement (inpatient stay) MS-DRG Code: `470`	—	$23,573	$19,432	1.2×
Heart stent placement (inpatient stay) MS-DRG Code: `322`	—	$22,619	$17,936	1.3×
Digestive disorders treatment (inpatient stay) MS-DRG Code: `392`	—	$9,755	$8,223	1.2×
Total hip replacement CPT Code: `27130`	$3,234	$3,234	$13,413	0.2×
Total knee replacement CPT Code: `27447`	$3,230	$3,230	$13,523	0.2×
Cataract surgery with lens implant CPT Code: `66984`	$3,650	$2,792	$2,540	1.1×
C-section delivery (full package) CPT Code: `59510`	$5,820	$2,464	$2,975	0.8×
Vaginal delivery (full package) CPT Code: `59400`	$5,272	$2,226	$2,680	0.8×
Gallbladder removal (laparoscopic) CPT Code: `47562`	$1,444	$1,444	$6,109	0.2×
Bunion correction surgery CPT Code: `28296`	$1,336	$816	$3,446	0.2×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$762	$762	$583	1.3×
Rabies immune globulin HCPCS Code: `90375`	$1,054	$729	$322	2.3×
Knee arthroscopy with meniscus repair CPT Code: `29881`	$1,394	$616	$3,372	0.2×
Inguinal hernia repair CPT Code: `49505`	$1,150	$590	$3,629	0.2×
Ultrasound, leg veins (duplex) CPT Code: `93970`	$561	$561	$272	2.1×
Breast lump removal CPT Code: `19120`	$1,100	$486	$3,875	0.1×
X-ray, lower back CPT Code: `72110`	$455	$455	$112	4.1×
Psychiatric evaluation (first visit) CPT Code: `90791`	$397	$397	$185	2.1×
Blood transfusion CPT Code: `36430`	$608	$415	$498	0.8×
Colonoscopy with biopsy CPT Code: `45380`	$2,181	$396	$1,256	0.3×
Psychotherapy session (60 minutes) CPT Code: `90837`	$351	$351	$181	1.9×
Speech therapy (language evaluation) CPT Code: `92507`	$369	$369	$86	unverified
Upper endoscopy with biopsy CPT Code: `43239`	$2,254	$341	$987	0.3×
X-ray, hip CPT Code: `73502`	$306	$306	$93	3.3×
Neurobehavioral status check CPT Code: `96116`	$311	$311	$231	1.3×
Colonoscopy (diagnostic) CPT Code: `45378`	$1,870	$313	$981	0.3×
X-ray, chest (two views) CPT Code: `71046`	$279	$279	$93	3.0×
X-ray, shoulder CPT Code: `73030`	$260	$260	$92	2.8×
X-ray, neck (cervical spine) CPT Code: `72040`	$256	$256	$93	2.8×
X-ray, ankle CPT Code: `73610`	$253	$253	$93	2.7×
X-ray, pelvis CPT Code: `72170`	$274	$274	$110	2.5×
X-ray, foot CPT Code: `73630`	$248	$248	$92	2.7×
X-ray, hand CPT Code: `73130`	$237	$237	$93	2.5×
X-ray, chest (single view) CPT Code: `71045`	$218	$218	$92	2.4×
Psychotherapy session (45 minutes) CPT Code: `90834`	$238	$238	$166	1.4×
Family therapy session CPT Code: `90847`	$236	$236	$173	1.4×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$120	$120	$64	1.9×
Office visit, established patient (30-39 min) CPT Code: `99214`	$293	$121	$123	1.0×
Hepatitis B immune globulin HCPCS Code: `90371`	$315	$127	$151	0.8×
Breathing treatment (nebulizer) CPT Code: `94640`	$144	$140	$201	0.7×
Physical therapy (gait training) CPT Code: `97116`	$161	$83	$33	2.5×
Physical therapy (manual therapy) CPT Code: `97140`	$111	$83	$34	2.4×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$159	$83	$35	2.4×
Occupational therapy (self-care training) CPT Code: `97535`	$149	$88	$38	2.3×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$160	$83	$38	2.2×
Physical therapy (functional capacity test) CPT Code: `97750`	$191	$83	$38	2.2×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$160	$83	$40	2.1×
Office visit, established patient (20-29 min) CPT Code: `99213`	$207	$86	$87	1.0×
New patient office visit (30-44 min) CPT Code: `99203`	$215	$106	$110	1.0×
MRI, brain (with and without contrast) CPT Code: `70553`	$2,787	$127	$511	0.2×
Psychological testing evaluation CPT Code: `96136`	$96	$96	$128	0.8×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$1,772	$89	$303	0.3×
MRI, lower back (no contrast) CPT Code: `72148`	$2,001	$95	$338	0.3×
MRI, brain (no contrast) CPT Code: `70551`	$2,032	$81	$343	0.2×
MRI, knee or other leg joint CPT Code: `73721`	$1,904	$86	$369	0.2×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$1,985	$93	$448	0.2×
Varicella (chickenpox) vaccine HCPCS Code: `90716`	$530	$530	$203	2.6×
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	$345	$345	$111	3.1×
Pneumococcal vaccine HCPCS Code: `90732`	$345	$345	$140	2.5×
Typhoid vaccine HCPCS Code: `90675`	$1,003	$298	$347	0.9×
Blood test, vitamin D CPT Code: `82306`	$212	$212	$31	6.8×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$182	$182	$11	unverified
Blood test, ferritin (iron stores) CPT Code: `82728`	$172	$172	$14	unverified
Blood test, PSA (prostate screen) CPT Code: `84153`	$187	$187	$19	unverified
Blood test, thyroid (TSH) CPT Code: `84443`	$190	$190	$18	unverified
Culture, blood CPT Code: `87040`	$187	$187	$11	unverified
Blood test, basic metabolic panel CPT Code: `80048`	$120	$120	$9	13.3×
Blood test, liver function panel CPT Code: `80076`	$101	$101	$9	11.2×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$116	$116	$14	8.3×
Hepatitis C antibody test CPT Code: `86803`	$118	$118	$15	7.9×
Blood test, vitamin B12 CPT Code: `82607`	$121	$121	$16	7.6×
DTaP vaccine (diphtheria, tetanus, pertussis) HCPCS Code: `90700`	$123	$123	$39	3.2×
Blood antibody screen CPT Code: `86850`	$148	$116	$46	2.5×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	$167	$128	$56	2.3×
Culture, bacterial CPT Code: `87070`	$127	$127	$9	unverified
Hepatitis B vaccine HCPCS Code: `90744`	$87	$87	$37	2.4×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$98	$98	$10	unverified
Blood test, lipase CPT Code: `83690`	$72	$72	$7	10.3×
Psychological testing by technician CPT Code: `96138`	$79	$79	$395	0.2×
Blood test, complete blood count (CBC) CPT Code: `85025`	$97	$97	$8	unverified
Blood test, clotting time (PTT) CPT Code: `85730`	$60	$60	$6	10.0×
Blood test, creatinine (kidney) CPT Code: `82565`	$45	$45	$5	9.0×
Blood test, sodium CPT Code: `84295`	$45	$45	$5	9.0×
Blood test, amylase CPT Code: `82150`	$62	$62	$7	8.9×
Electrocardiogram (ECG/EKG) CPT Code: `93000`	$55	$55	$25	2.2×
Group therapy session CPT Code: `90853`	$64	$64	$100	0.6×
Blood test, glucose (blood sugar) CPT Code: `82947`	$35	$35	$4	8.8×
Blood test, potassium CPT Code: `84132`	$34	$34	$5	6.8×
Blood test, magnesium CPT Code: `83735`	$46	$46	$7	6.6×
Flu vaccine injection HCPCS Code: `G0008`	$48	$48	$48	1.0×
Pneumonia vaccine injection HCPCS Code: `G0009`	$48	$48	$49	1.0×
Colorectal cancer screening HCPCS Code: `G0010`	$48	$48	$49	1.0×
Hospital observation (per hour) HCPCS Code: `G0378`	$97	$72	$86	0.8×
Blood test, calcium CPT Code: `82310`	$41	$41	$5	8.2×
Extended office visit (prolonged) HCPCS Code: `G2212`	$72	$30	$33	0.9×
Orthotic fitting and training CPT Code: `97760`	$151	$41	$51	0.8×
Diagnostic mammogram (both breasts) CPT Code: `77066`	$501	$51	$148	0.3×
CT scan, pelvis CPT Code: `72192`	$1,302	$56	$163	0.3×
CT scan, chest (no contrast) CPT Code: `71250`	$1,325	$56	$167	0.3×
Screening mammogram (both breasts) CPT Code: `77067`	$421	$39	$123	0.3×
Ultrasound, abdomen (complete) CPT Code: `76700`	$437	$42	$134	0.3×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$1,313	$52	$168	0.3×
CT scan, neck (cervical spine) CPT Code: `72125`	$1,316	$52	$169	0.3×
Ultrasound, pelvis CPT Code: `76856`	$170	$36	$130	0.3×
CT scan, head (no contrast) CPT Code: `70450`	$1,042	$44	$160	0.3×
CT scan, sinuses CPT Code: `70486`	$1,101	$45	$166	0.3×
CT scan, head (with and without contrast) CPT Code: `70470`	$1,557	$66	$258	0.3×
CT scan, head (with contrast) CPT Code: `70460`	$1,283	$59	$242	0.2×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$58	$58	$3	unverified
Diagnostic procedure preparation HCPCS Code: `G0279`	$64	$27	$35	0.8×
Ultrasound, abdomen (limited) CPT Code: `76705`	$464	$31	$126	0.2×
Ultrasound, thyroid and neck CPT Code: `76536`	$589	$29	$132	0.2×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$45	$45	$4	unverified
Flu vaccine (high dose) HCPCS Code: `90656`	$64	$13	$25	0.5×
Blood test, hemoglobin CPT Code: `85018`	$29	$29	$3	unverified
Blood test, clotting time (PT/INR) CPT Code: `85610`	$43	$43	$5	unverified

Showing top 25 high-impact procedures of 118 total

Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 43.5%

Audit a Bill or Quote at Porter Hospital Inc (Zero PHI Required)

CMS CCN: 471307

CPT 451

Select Procedure to Audit:

Fair BaseRate™ $30,775

Medicare Rate $23,504

Self-Pay Cash Request Quote

Insurer Median $38,581

1. Amount on Your Bill or Quote ($) Pre-filled with Porter Hospital Inc’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: $40,306 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $40,306

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (43.5% of gross = $40,306).

Step 2 · Cash vs. Insurance Arbitrage Request Prompt-Pay Quote

Compare Prompt-Pay Cash Rate Against Remaining Deductible

Ask Porter Hospital Inc's billing desk for their written 45 CFR § 180 discounted self-pay cash price and Good Faith Estimate under the No Surprises Act.

Step 3 · Fair BaseRate Target +$61,819 Above Fair BaseRate

Negotiate Toward $30,775 Fair BaseRate ($23,504 Medicare)

Your bill ($92,594) is $61,819 above the denoised Fair BaseRate ($30,775) and 3.9× the $23,504 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)

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 (43.5% 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 Overall3/5 Stars (3/5)

Safety Composite64/100

Would Recommend65%

Rated 9 or 10 (HCAHPS)65%

Median ER Wait172 min

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

Source: CMS Hospital Care Compare (282 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 Quality & Price Benchmark Pareto Frontier (Price + Quality)

2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Porter Hospital Inc.

Price Index: 0.57× regional baseline

Quality: 55/100 CMS composite

Median Household Income$88,478U.S. Census ACS

Local Uninsured Share4.6%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 58/100 · Caution CMS CCN 471307

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 471307) ↗ CMS HCRIS Cost Reports ↗

Published MRF FileCMS_45_CFR_180_FILING.json

Publication / Vintage2026-04-28

Validated Rate Rows2,086 (CMS v3.0.0)

File Integrity DigestVerified · CCN 471307

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