Southwestern Vermont Medical Center
100 Hospital Drive, Bennington, VT 05201 · 122 Priced Procedures · 72% Patient Recommendation
Typical commercial prices here are 17% below the fair benchmark (0.83×) after accounting for local nurse/doctor wages and patient complexity.
3-Star CMS clinical quality rating paired with 0.83× fair market pricing.
Uniform Value Leader · Low-Cost Across Departments
Southwestern Vermont Medical Center maintains low, disciplined commercial pricing across both routine shoppable procedures (0.8× Medicare, p50 0.83× Fair BaseRate) and emergency/ancillary services (1.0× Medicare, p75 0.95× Fair BaseRate). Both insured and self-pay patients benefit from below-benchmark rates across departments.
Where They're Good (Patient & Payer Edge)
- Elective shoppable care is priced 17% below peer Fair BaseRate (0.83×)
- Self-pay cash beats commercial insurance on 7% of shoppable procedures (99/100 Cash Honesty)
- CMS clinical safety score (63/100 safety score) with 72% patient recommendation
- IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (21.3% AGB cap)
Where You Can Get Burned (Markup Traps)
- Even at low-cost facilities (0.83× 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 (2.2×) services average 1.25× higher multiples than routine shoppable care (0.8×)
- Even at low-cost facilities (0.83× 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.
- Consolidated metro market (HHI 10,000) limits in-network hospital competition (Highly Concentrated Monopoly (>2,500))
Pre-scheduled outpatient procedures where patients can comparison-shop.
Emergency, inpatient DRG, lab, and specialty drug lines billed after admission.
Detects median-gaming when upper-quartile codes spike above the p50 median.
Procedure Prices at Southwestern Vermont Medical Center
High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 122 published procedures.
| Procedure & Billing Code | This Hospital | vs. Fair |
|---|---|---|
| Sepsis treatment (inpatient stay) MS-DRG Code: 871 | $18,137 | 1.0× |
| Hip or knee replacement (inpatient stay) MS-DRG Code: 470 | $17,213 | 0.9× |
| Heart stent placement (inpatient stay) MS-DRG Code: 322 | $16,680 | 0.9× |
| Digestive disorders treatment (inpatient stay) MS-DRG Code: 392 | $7,187 | 0.9× |
| Total knee replacement CPT Code: 27447 | $3,462 | 0.3× |
| Total hip replacement CPT Code: 27130 | $2,493 | 0.2× |
| C-section delivery (full package) CPT Code: 59510 | $2,383 | 0.8× |
| Vaginal delivery (full package) CPT Code: 59400 | $2,160 | 0.8× |
| Knee arthroscopy with meniscus repair CPT Code: 29881 | $980 | unverified |
| Injection procedure for pain management HCPCS Code: G0260 | $902 | unverified |
| Bunion correction surgery CPT Code: 28296 | $828 | 0.2× |
| Blood transfusion CPT Code: 36430 | $781 | 1.6× |
| Breast lump removal CPT Code: 19120 | $691 | 0.2× |
| Gallbladder removal (laparoscopic) CPT Code: 47562 | $707 | 0.1× |
| Rabies immune globulin HCPCS Code: 90375 | $575 | unverified |
| Cataract surgery with lens implant CPT Code: 66984 | $505 | 0.2× |
| Inguinal hernia repair CPT Code: 49505 | $476 | 0.1× |
| Upper endoscopy with biopsy CPT Code: 43239 | $349 | 0.4× |
| MRI, brain (with and without contrast) CPT Code: 70553 | $365 | unverified |
| CT scan, abdomen and pelvis (with contrast) CPT Code: 74177 | $365 | unverified |
| Colonoscopy with biopsy CPT Code: 45380 | $336 | 0.3× |
| X-ray, hip CPT Code: 73502 | $299 | 3.2× |
| Sleep study (overnight, in lab) CPT Code: 95810 | $287 | 0.3× |
| Ultrasound, leg veins (duplex) CPT Code: 93970 | $228 | 0.8× |
| CT scan, abdomen and pelvis (no contrast) CPT Code: 74176 | $247 | 0.8× |
Audit a Bill or Quote at Southwestern Vermont Medical Center (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $9,280
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (21.3% of gross = $9,280).
Compare Prompt-Pay Cash Rate Against Remaining Deductible
Ask Southwestern Vermont Medical Center's billing desk for their written 45 CFR § 180 discounted self-pay cash price and Good Faith Estimate under the No Surprises Act.
Negotiate Toward $19,087 Fair BaseRate ($14,117 Medicare)
Your bill ($43,529) is $24,442 above the denoised Fair BaseRate ($19,087) and 3.1× the $14,117 Medicare rate.
Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)
Hospital-Specific CMS HCRIS Benchmark (21.3% 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.
Clinical Quality, Patient Experience & Infection Benchmarks
Healthcare-Associated Infections (CDC NHSN / CMS HAI)
1.00 SIR = National Predicted Baseline (Lower Is Safer)CMS Price Transparency Administrative Enforcement Log
Factual public administrative actions published by the Centers for Medicare & Medicaid Services regarding 45 CFR § 180 compliance at Southwestern Vermont Medical Center. Prior administrative notices do not necessarily reflect current compliance status.
- 2024-05-16·administrative_or_closure
Closure Notice
Recorded - 2024-02-13·warning_notice
Warning Notice
Recorded
Source: CMS Hospital Care Compare (324 completed HCAHPS patient surveys). Clinical quality metrics summarize historical facility-wide cohorts and are not medical advice for individual care decisions.
How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings
2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Southwestern Vermont Medical Center.
Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings
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.