All Vermont Acute Care Community HospitalsPhysician and Hospital Pricing of Common Outpatient Procedures - Gross ChargesUnder Act 53, the information in the table below was required to be submitted by the hospitals to the Vermont Department of Banking, Insurance, Securities & Health Care Administration. Most of the charges in the table are effective for the period of October 1, 2010 through September 30, 2011. They are based on Common Procedural Terminology (CPT®) codes, which are defined as "a listing of descriptive terms and identifying codes for reporting medical services and procedures performed by physicians. The purpose of the terminology is to provide a uniform language that will accurately describe medical, surgical, and diagnostic services, and will thereby provide an effective means for reliable nationwide communication among physicians, patients, and third parties." (CPT® 2011 Standard Edition codebook - American Medical Association)The tables of CPT code charges shown on BISHCA’s website provide hospital and physician gross charge information for selected commonly used outpatient procedures and related physician services. The charges listed are for the procedures themselves and do not represent other procedures that your physician may order or recommend. For some procedures, additional services such as blood collection or sedation may be required in conjunction with delivering the listed procedure. There may also be charges for supplies and pharmaceuticals used in the procedure. To completely understand all possible charges that may apply for services received, please call your hospital and/or physician. Every patient event may have unique circumstances that could require additional services determined at the time of care, which can affect your total charges. The gross charges shown do NOT take into account any discounts or insurance. Please see the "Frequently Asked Questions" page for more information about pricing issues and considerations.For each table:-All charges shown are for hospitals and hospital-employed physicians only.-“N/A” for hospital chargesindicates that the hospital does not perform this particular procedure. Check with the hospital as it may perform a similar procedure that is not listed.-“N/A” for physician chargesindicates that the hospital does not employ any physician who performs the service. In these cases, you may expect a separate charge from your physician or another doctor not employed directly by the hospital.-A “$0” indicatesthat there is no separate charge for this portion of a procedure or service.- The Hospital System Averages at the bottom of the table are the averages of the charges shown for each CPT code, and do not include any charges that are "N/A".- Note that many of the codes on the list are diagnostic tests in which the physician charge component represents the medical interpretation of a resulting image, lab specimen analysis, etc.® CPT is a registered trademark of the American Medical Association.BISHCA Act 53 Comparative Pricing Summary
All Vermont Acute Care Community HospitalsTable 3D - Emergency Services- These charges do NOT include charges for tests or procedures performed during the visit. Please check with your hospital and physician for detailsabout pricing and your specific circumstances.- The different "levels" in the CPT code descriptions indicate levels of complexity of the ER visit. A higher level number is more complex than a lower number.CPT Code9928199282992839928499285 HospitalDescriptionEmergency room visit, level 1Emergency room visit, level 2Emergency room visit, level 3Emergency room visit, level 4Emergency room visit, level 5Hospital Charge$75$218$348$554$818Physician Charge$52$101$153$289$426Total Charge$127$319$501$843$1,244Hospital Charge$160$282$398$719$997Physician Charge$38$71$114$207$309Total Charge$197$353$512$926$1,306Hospital Charge$89$167$252$473$726Physician Charge$45$80$125$225$319Total Charge$134$247$377$698$1,045Hospital Charge$191$408$636$1,023$1,519Physician Charge$127$170$256$410$605Total Charge$318$578$892$1,433$2,124Hospital Charge$178$290$389$603$860Physician Charge$61$102$159$282$506Total Charge$239$392$548$885$1,366Hospital Charge$171$332$492$662$686Physician Charge$30$58$88$165$244Total Charge$201$390$580$827$930Hospital Charge$180$202$305$495$804Physician ChargeN/AN/AN/AN/AN/ATotal ChargeN/AN/AN/AN/AN/AHospital Charge$152$235$431$479$671Physician Charge$152$218$378$485$609Total Charge$304$453$809$964$1,280Hospital Charge$212$212$382$578$578Physician Charge$90$121$268$417$651Total Charge$302$333$650$995$1,229Hospital Charge$78$121$159$592$940Physician Charge$93$111$179$308$371Total Charge$171$232$338$900$1,311Hospital Charge$122$155$26$540$817Physician Charge$105$142$213$315$525Total Charge$227$297$239$855$1,342Hospital Charge$170$253$298$515$771Physician Charge$43$75$162$252$393Total Charge$213$328$460$767$1,164Hospital Charge$124$124$256$369$567Physician Charge$81$83$186$281$395Total Charge$205$207$442$650$962Hospital Charge$325$371$638$794$843Physician Charge$52$87$108$172$257Total Charge$377$458$746$966$1,100Hospital Charge$159$241$358$600$828Physician Charge$75$109$184$293$432Total Charge$234$350$542$893$1,260Mt. Ascutney Hospital & Health CenterNorth Country HospitalSouthwestern Vermont Medical CenterSpringfield HospitalHospital System AveragesNortheastern Vermont Regional HospitalNorthwestern Medical CenterPorter HospitalRutland Regional Medical CenterBrattleboro Memorial HospitalCentral Vermont Medical CenterCopley HospitalFletcher Allen Health CareGifford Medical CenterGrace Cottage HospitalBISHCA Act 53 Comparative Pricing Summary