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Office visit, new patient, 45-59 min

CPT 99204 · negotiated-rate distribution across hospitals in VT

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Hospitals
6
Min
$159.11
Median
$271.34
Max
$413.50
Range multiplier
2.6×

By payer (34 payers with published rates)

PayerHosp.RatesMinMedianMaxRange×
Blue Cross Blue Shield543$101.64$273.52$558.455.5×
harvard pilgrim health care135$123.62$299.85$539.844.4×
tufts health plan133$171.21$370.45$567.573.3×
UnitedHealthcare533$72.60$296.21$589.488.1×
Cigna524$125.06$297.73$589.484.7×
First Health423$125.06$367.63$601.894.8×
Aetna522$121.26$372.43$601.895.0×
mvp317$106.30$220.74$416.303.9×
capital district physicians' health plan315$121.26$181.50$315.032.6×
Anthem BCBS213$123.62$175.08$337.992.7×
mvp healthcare113$123.62$350.01$558.454.5×
Multiplan213$148.34$377.23$601.894.1×
vermont health plan111$192.79$380.62$555.352.9×
health new england110$304.00$412.51$601.892.0×
wellpath39$141.90$175.08$343.822.4×
harvard pilgrim38$147.75$264.64$500.103.4×
Humana46$101.64$122.05$125.061.2×
martins point35$121.26$159.11$191.101.6×
fidelis care25$109.13$143.82$143.821.3×
VA Health34$121.26$125.06$125.061.0×
wellsense13$109.93$132.27$133.811.2×
ebpa13$312.18$312.18$381.921.2×
nppn13$326.70$326.70$446.401.4×
magnacare12$290.40$343.60$396.801.4×
veterans choice12$121.26$123.16$125.061.0×
WellCare12$129.80$130.56$131.311.0×
medical corporation12$245.10$264.58$284.051.2×
martin's point12$123.62$124.34$125.061.0×
amerihealth-caritas11$109.93$109.93$109.931.0×
new hampshire healthy families11$109.93$109.93$109.931.0×
st. regis11$125.06$125.06$125.061.0×
the vermont health plan11$326.00$326.00$326.001.0×
mvp health plan, inc.11$409.00$409.00$409.001.0×
hphc insurance company, inc.11$418.00$418.00$418.001.0×

By hospital (top 200 by negotiated median, descending)

HospitalCitySTPayersGrossCashNeg minNeg medianNeg max
Mt Ascutney Hospital And Health CentWindsorVT8$449.00$359.00$325.00$413.50$427.00
Brattleboro Memorial HospitalBrattleboroVT18$620.50$434.35$109.93$361.13$601.89
University Of Vermont Medical CenterBurlingtonVT17$496.00$496.00$72.60$271.34$490.89
Central Vermont HospitalBarreVT12$625.12$625.12$121.53$238.88$500.10
Porter HospitalMiddleburyVT16$380.00$380.00$106.30$159.11$358.43
Copley Hospital Inc.MorrisvilleVT0$305.00$244.00

Median is taken across all payer × plan combinations the hospital publishes. Cash and gross are the latest snapshot values. Range multiplier (max ÷ min) is a quick way to see which hospitals or payers vary the most.